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Propofoleinsatz für Hals-Nasen-Ohren-Eingriffe im Kindesalter

Praktikabilität, Qualität und Kosteneffektivität verschiedener Narkoseverfahren zur Adenotomie bei Kindern

Propofol for paediatric patients in ear, nose and throat surgery

Practicability, quality and cost-effectiveness of different anaesthesia procedures for adenoidectomy in infants

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Zusammenfasssung

Hintergrund

Ziele der Studie waren die Verbesserung des Patientenkomforts sowie die Reduktion von Anästhesiekosten und Raumluftbelastung durch den Einsatz von Propofol zur Adenotomie.

Material und Methoden

Zur elektiven Adenotomie erhielten 103 Kinder (1–5 Jahre alt) randomisiert entweder Sevofluran-Lachgas-Sauerstoff (Gruppe 1), Sevofluran-Luft/Alfentanil (Gruppe 2), Alfentanil-Propofol nach Einleitung mit Sevofluran (Gruppe 3) oder eine TIVA mit Alfentanil-Propofol (Gruppe 4).

Ergebnisse

Nach kontinuierlicher Propofolgabe traten Unruhezustände und Erbrechen signifikant seltener auf. Der postoperative Dipidolorbedarf und die Anästhesiekosten waren signifikant geringer als bei inhalativer Narkoseführung.

Schlussfolgerung

Der Einsatz von Propofol für Hals-Nasen-Ohren-(HNO-)Eingriffe im Kleinkind- und Vorschulalter bietet Vorteile für die Aufwachphase und ist kostengünstiger als eine Inhalationsanästhesie mit Sevofluran. Bei intraoralen Eingriffen kann die bei der Anwendung ungeblockter Tuben erhöhte Narkosegasbelastung, v. a. des Operateurs, vermieden werden.

Abstract

Background

The aim of this study was an improvement in patient comfort, reduction of anaesthesia costs and room contamination by the use of propofol for adenoidectomy.

Methods

A total of 103 infants (aged 1–5 years) undergoing elective adenoidectomy were randomized for anaesthesia with sevoflurane-nitrous oxide/oxygen (group 1), sevoflurane-air/alfentanil (group 2), alfentanil-propofol under induction with sevoflurane (group 3) or alfentanil-propofol (group 4).

Results

Using propofol, postoperative agitation and emesis were significantly less and the anaesthesia costs as well as the need for analgesics was reduced compared to inhalative anaesthesia.

Conclusions

The use of propofol for preschool children undergoing ear, nose and throat (ENT) surgery seems to be advantageous because of less postoperative agitation, emesis and costs.

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  1. Klinik und Poliklinik für Anästhesiologie und Intensivtherapie, Universitätsklinikum, Liebigstraße 20a, 04103, Leipzig AöR

    K. Auerswald, K. Behrends, U. Burkhardt & D. Olthoff

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  1. K. Auerswald
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  2. K. Behrends
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  3. U. Burkhardt
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  4. D. Olthoff
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Correspondence to K. Auerswald.

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Auerswald, K., Behrends, K., Burkhardt, U. et al. Propofoleinsatz für Hals-Nasen-Ohren-Eingriffe im Kindesalter. Anaesthesist 55, 846–853 (2006). https://doi.org/10.1007/s00101-006-1046-z

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