Decreasing the need for mechanical ventilation after surgery forretinopathy of prematurity: sedoanalgesia vs. general anesthesia

Authors: AYŞE ÜLGEY, IŞIN GÜNEŞ, ADNAN BAYRAM, RECEP AKSU, CİHANGİR BİÇER, FATİH UĞUR, ÇAĞATAY KARACA, ADEM BOYACI

Abstract: Background/aim: Premature infants experience more respiratory problems after surgical procedures. We aimed to compare general anesthesia with sedation regarding the need for postoperative mechanical ventilation in infants undergoing retinopathy of prematurity (ROP) surgery. Materials and methods: Sixty patients who underwent laser surgery for ROP were included in this study. This study was performed between October 2010 and December 2012. The sedation group (Group S, n = 30) received 1 mg/kg ketamine and 1 mg/kg propofol as a bolus for induction. The patients then received an infusion of 100-150 μg kg^-1 min^-1 propofol and 0.25 mg kg^-1 h^-1 ketamine for maintenance. In the general anesthesia group (Group G, n = 30), anesthesia was induced using 8% sevoflurane by inhalation with 50% nitrous oxide in oxygen. Anesthesia was maintained with sevoflurane (2%) and 50% nitrous oxide in oxygen. Results: There was no difference in gestational age, birth weight, current age, or current body weight between the two groups. Preoperative medical histories of the groups were similar. Two patients in Group S and 11 patients in Group G required postoperative mechanical ventilation (P = 0.010). Blood pressures and heart rates were similar. Conclusion: In premature infants, sedoanalgesia administration reduced the need for postoperative mechanical ventilation after surgery for ROP.

Keywords: Prematurity, retinopathy, propofol, ketamine, sedation

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