BACKGROUND: Remifentanil and sevoflurane are characterized by rapid emergence from anesthesia. Therefore, propofol-remifentanil anesthesia (PR) and sevoflurane-nitrous oxide anesthesia (SN) were compared with regard to the recovery characteristics in children.

METHODS: Sixty children scheduled for tonsillectomy were randomly assigned to receive PR (n = 30) or SN (n = 30). The PR group was induced by remifentanil, propofol and vecuronium, maintained with infusion of remifentanil and propofol. The SN group was induced by sevoflurane, nitrous oxide, vecuronium maintained with sevoflurane in 50% nitrous oxide. At the end of operation, all anesthetics were discontinued and 100% oxygen was inspirated in both groups. The times to spontaneous breathing, extubation, eye opening, PACU discharge were assessed and postoperative nausea/vomiting, agitation were noted.

RESULTS: Spontaneous breathing occurred after 9.29 ± 1.02 minutes (PR) versus 6.85 ± 0.60 minutes (SN) (P < 0.05), extubation after 9.19 ± 0.91 minutes versus 8.87 ± 0.67 minutes, eye opening after 9.47 ± 1.01 minutes versus 14.85 ± 0.80 minutes (P < 0.05) and PACU discharge after 21.32 ± 2.01 minutes versus 27.55 ± 1.72 minutes (P < 0.05). The occurrence of postoperative nausea/vomiting was 7% (PR) versus 13% (SN), and the incidence of agitation was 60% (PR) versus 83% (SN).

CONCLUSIONS: It was observed that the recovery of propofol-remifentanil anesthesia was faster than that of sevoflurane-nitrous oxide anesthesia, except spontaneous breathing. The incidences of postoperative nausea/vomiting were low in both groups, and the incidences of agitation were higher in SN group than in PR group.