Postoperative Analgesia in Children Undergoing Adenotonsillectomy Under Sevoflurane Versus Propofol-Based Anesthesia: Randomized Controlled Trial

Background: The field of pediatric pain changed greatly in the past decades. However, the number of children who experience moderate to severe postoperative pain, even with analgesic treatment, remains significant. If an intravenous or inhalational anesthetic would include in itself all the components of general anesthesia, like hypnosis, analgesia, and amnesia, it would represent a really ideal anesthetic. There is some evidence that propofol may reduce post-operative pain. This debate on the early potential analgesic efficacy of propofol compared with sevoflurane during the postoperative peroid in children was evident.Aim: To compare the postoperative potential analgesic effects of propofol versus sevoflurane-based anesthesia in children undergoing adenotonsillectomy.Methods: This study was a prospective comparative randomized, single blinded trial conducted to 60 ASA physical status I and II children aged 3-10 years underwent adenotonsillectomy under general anesthesia, patients randomly assigned into one of two equal groups sevoflurane and propofol group. The primary outcome was pain score assessed by Faces Pain Scale (FPS) postoperatively. Secondary outcomes included recovery time and adverse events within the first 4 hours.Results: The current study showed that the postoperative resting and swallowing face pain score was significantly lower in the propofol group than sevoflurane group, postoperative agitation scores were significantly lower in the propofol group than sevoflurane group in the first 30 minutes of early postoperative period then no significant differences were found from 40 minutes to the fourth postoperative hour, the 4 hours postoperative paracetamol consumption was significantly greater in the sevoflurane group than in the propofol group and postoperative nausea and vomiting was less in the propofol group than in sevoflurane group (p 0.001).Conclusion: The use of propofol is more advantageous than sevoflurane for induction and maintenance of general anesthesia in children undergoing adenotonsillectomy. It decreases early postoperative pain, analgesic consumption, postoperative agitation and postoperative nausea and vomiting.However, the use of propofol in induction and maintenance of anesthesia is associated with an increase the time for recovery.