Effets du propofol sur la pression intraoculaire dans la chirurgie du strabisme de l'enfant

Propofol was assessed for eye surgery in 20 children, ASA group I or II, 2–14 year-old, randomly assigned to 2 equal groups. Premedication, analgesia and muscle paralysis were similar in both groups. Group P patients were given an induction dose of 4 mg · kg−1 propofol, followed by an infusion of 15 mg · kg−1 · h−1 for the first half hour, and then 10 mg · kg−1 · h−1 to maintain anaesthesia. Group C patients were given 10 mg · kg−1 thiopentone for induction and halothane for maintenance. The quality of anaesthesia was assessed by monitoring adverse effects, heart rate, blood pressure, the length of anaesthesia, the delay of the first spontaneous breath and eye opening, and extubation. Intraocular pressure was measured before and 3 min after intubation, and 5 min after extubation. The quality of anaesthetic induction and maintenance were very similar in both groups. Pain occured more frequently at the injection site with propofol (p < 0.01). Children in group P recovered more quickly, and extubation was possible much earlier in this group (p < 0.05). However, restlessness was significantly more frequent in group P (n = 9) than in group C (n = 1) (p < 0.01). Systolic, diastolic blood pressure and heart rate were significantly lower in group P (p < 0.05 ; 0.001 ; 0.001 respectively). No significant decrease in intraocular pressure in both groups was observed. The use of propofol for eye surgery in children is acceptable, despite some restlessness during recovery.