EFFICACY OF SEVOFLURANE VERSUS PROPOFOL FOR INTUBATION WITHOUT USING NEUROMUSCULAR BLOCKERS IN CHILDREN UNDERGOING ELECTIVE SURGERY AT TERTIARY CARE HOSPITAL
Keywords:Pediatric Anesthesia, Endotracheal Intubation, Sevoflurane, Propofol, Neuromuscular Blockers, Clinical Effectiveness, Randomized Controlled Trial.
BACKGROUND: The process of pediatric endotracheal intubation in the context of elective procedures
presents distinct difficulties, as the selection of induction agents directly influences the resulting clinical
results. Using neuromuscular blockers has inherent hazards, necessitating investigating other approaches to
attain ideal intubation circumstances. The present research aimed to examine and compare the effectiveness
of sevoflurane and propofol in pediatric intubation, particularly in the absence of neuromuscular blockers.
OBJECTIVE: To compare the efficacy of Sevoflurane versus Propofol for intubation without using
neuromuscular blockers in children undergoing elective surgeries at a tertiary care hospital. METHODS:
A randomized controlled trial was conducted in the Department of Anesthesiology, Patel Hospital Karachi,
over a period of six months. The research comprised a cohort of sixty-two pediatric patients aged 1 month
to 5 years. These patients were categorized as ASA status I-II. The individuals in question were slated to
undergo elective medical operations while under the effects of general anesthesia. The individuals were
randomly assigned to receive either sevoflurane or propofol throughout the induction procedure. This
study's primary outcome of interest was clinical effectiveness, which was assessed by evaluating intubation
ratings. Moreover, several other attributes were recorded, including patient demographics, length of
laryngoscopy, ASA classification, and incidences of adverse events. RESULTS: The sevoflurane group
had a notably greater level of clinical efficacy, as seen by 75.8% of patients obtaining successful intubation,
in contrast to the propofol group, where only 51.6% of patients achieved successful intubation p-value
<0.001. A significant proportion of patients in both cohorts had favorable outcomes regarding intubation
ratings, ranging from satisfactory to outstanding. The incidence of adverse effects, such as laryngospasm
and the administration of succinylcholine, was infrequent and seen in a minority of the patient population.
CONCLUSION: Sevoflurane has been identified as a more effective induction drug for pediatric
intubation without neuromuscular blockers during elective surgical procedures. The promise of sevoflurane
as an alternative to conventional muscle relaxants in pediatric anesthesia is indicated by its clinical efficacy
and excellent safety profile. Additional multicenter trials should be conducted to verify these results and
establish sevoflurane as the preferred option for pediatric intubation.
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