A comparison of thiopentone/isoflurane anaesthesia vs propofol infusion in children having repeat minor haematological procedures

We have performed a randomized, cross over study in 22 children suffering from acute leukaemia, who underwent repeated anaesthesia for bone marrow aspiration and lumbar puncture. For their first anaesthetic, the children (aged 3-10 years old) received, either a thiopentone/isoflurane anaesthetic or intravenous propofol, both supplemented with nitrous oxide. On a second occasion they received the alternative technique. Of those children receiving thiopentone/isoflurane, 32% had significant coughing during anaesthesia, two progressing to laryngospasm requiring 100% oxygen. None of the patients receiving propofol had a respiratory disturbance (P = 0.016). 68% of the children preferred the propofol anaesthetic. Only one child in the thiopentone/isoflurane group preferred this technique. Twenty-seven per cent had no preference. There was no significant difference in length of anaesthetic time (P=0.07) or the time taken for recovery (P=0.17) between the two groups. There was a large individual variation in propofol requirements and movement was common during stimulation of patients in this group, though this did not adversely affect the surgical procedure.