***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background : Sevoflurane , with its low pungency and low blood and tissue solubility , is an attractive anaesthetic in paediatric outpatient surgery .  Propofol‐anaesthesia is recognised for its rapid and clear‐headed emergence . This study was design ed to compare emergence and recovery characteristics of sevoflurane and propofol anaesthesia for tonsillectomy in children The purpose of this study was to evaluate the haemodynamic changes during induction , as well as the speed and quality of recovery when propofol ( vs thiopentone and /or halothane ) was used for induction and maintenance of anaesthesia in paediatric out patients . One hundred unmedicated children , 3–12-yr-old , scheduled for ambulatory surgery were studied . The most common surgical procedures performed were eye muscle surgery ( 42 % ) , plastic surgery ( 21 % ) , dental restoration ( 15 % ) , and urological procedures ( 15 % ) . The children were r and omized to an anaesthetic regimen for induction/maintenance as follows : propofol/propofol infusion ; propofol/halothane ; thiopentone/halothane ; halothane for both induction and maintenance . Succinylcholine 1.5 mg · kg−1 was used to facilitate tracheal intubation and N2O/O2 were used as the carrier gases in each case . All maintenance drugs were titrated according to the clinical response of the patient to prevent movement and /or maintain BP ± 20 % of baseline . Two patients ( 4 % ) who received propofol expressed discomfort during injection . The mean propofol dose required to prevent movement was 267 ± 83 μg · kg−1 · min−1 . The overall pattern of haemodynamic changes , as well as awakening ( extubation ) times were not different among the four groups . Children who received propofol recovered faster ( 22 vs 29–36 min ) ( P < 0.05 ) , were discharged home sooner ( 101 vs 127–144 min ) ( P < 0.05 ) , and had less postoperative vomiting ( 4 vs 24–48 % ) ( P < 0.05 ) than all others . There were no serious complications or adverse postoperative sequelae in any of the patients in the study . It is concluded that induction and maintenance of anaesthesia with propofol is a well-tolerated anaesthetic technique in children , and is associated with faster recovery and discharged as well as less vomiting than when halothane is used . RésuméL’objet de cette étude est d’évaluer les changements hémodynamiques à l’induction ainsi que la vitesse et la qualité du réveil , lorsque le propofol ( versus thiopental et/ou halothane ) est utilisé pour l’induction et l’entretien de l’anesthésie d’enfants en ambulatoire . On a étudié 100 enfants dépourvus de traitement , entre 3 et 12 ans , programmés pour une chirurgie ambulatoire . Les chirurgies les plus habituelles sont la cure de strabisme ( 42 % ) , la chirurgie plastique ( 21 % ) , la restauration dentaire ( 15 % ) et les interventions urologiques ( 15 % ) . Les enfants sont distribués aléatoirement pour une anesthésie d’induction/entretien comme suit : propofol/infusion de propofol ; propofol/ halothane ; thiopental/halothane ; halothane pour l’induction et l’entretien . On a utilisé la succinylcholine 1,5 mg · kg−1 pour faciliter l’intubation trachéale et le N2O/O2 est utilisé comme véhicule gazeux dans tous les cas . Pour l’entretien de l’anesthésie , les agents sont titrés en fonction de la réponse clinique du patient afin de prévoir les mouvements et/ou de maintenir la pression artérielle à ±20 % de la valeur de base . Deux patients ( 4 % ) ont manifesté un inconfort pendant l’injection de propofol . La dose moyenne de propofol requise pour prévenir le mouvement est de 267 ± 83 μg · kg−1 · min−1 . Autant le profil général des variations hémodynamiques que le moment du réveil ( extubation ) sont identiques dans les quatre groupes . Les enfants qui reçoivent le propofol se réveillent plus vite ( 22 secondes versus 29–36 min ) , ( P < 0,05 ) sont renvoyés plus tôt à la maison ( 101 versus 127–144 min ) ( P < 0,05 ) et ont moins de vomissements post-opératoires ( 4 versus 24–48 % ) ( P < 0,05 ) . Il n’y a pas eu de complications sérieuses ni de séquelles postopératoires chez aucun des patients de l’étude . On en conclut que l’induction et l’entretien de l’anesthésie avec le propofol est une technique bien tolérée chez l’enfant , associée avec un réveil et un départ plus rapides ainsi que des vomissements moindres que lors de l’utilisation d’halothane BACKGROUND Perioperative respiratory adverse events in children are one of the major causes of morbidity and mortality during paediatric anaesthesia .  We aim ed to identify associations between family history , anaesthesia management , and occurrence of perioperative respiratory adverse events . METHODS We prospect ively included all children who had general anaesthesia for surgical or medical interventions , elective or urgent procedures at Princess Margaret Hospital for Children , Perth , Australia , from Feb 1 , 2007 , to Jan 31 , 2008 . On the day of surgery , anaesthetists in charge of paediatric patients completed an adapted version of the International Study Group for Asthma and Allergies in Childhood question naire . We collected data on family medical history of asthma , atopy , allergy , upper respiratory tract infection , and passive smoking . Anaesthesia management and all perioperative respiratory adverse events were recorded . FINDINGS 9297 question naires were available for analysis . A positive respiratory history ( nocturnal dry cough , wheezing during exercise , wheezing more than three times in the past 12 months , or a history of present or past eczema ) was associated with an increased risk for bronchospasm ( relative risk [ RR ] 8.46 , 95 % CI 6.18 - 11.59 ; p<0.0001 ) , laryngospasm ( 4.13 , 3.37 - 5.08 ; p<0.0001 ) , and perioperative cough , desaturation , or airway obstruction ( 3.05 , 2.76 - 3.37 ; p<0.0001 ) . Upper respiratory tract infection was associated with an increased risk for perioperative respiratory adverse events only when symptoms were present ( RR 2.05 , 95 % CI 1.82 - 2.31 ; p<0.0001 ) or less than 2 weeks before the procedure ( 2.34 , 2.07 - 2.66 ; p<0.0001 ) , whereas symptoms of upper respiratory tract infection 2 - 4 weeks before the procedure significantly lowered the incidence of perioperative respiratory adverse events ( 0.66 , 0.53 - 0.81 ; p<0.0001 ) . A history of at least two family members having asthma , atopy , or smoking increased the risk for perioperative respiratory adverse events ( all p<0.0001 ) . Risk was lower with intravenous induction compared with inhalational induction ( all p<0.0001 ) , inhalational compared with intravenous maintenance of anaesthesia ( all p<0.0001 ) , airway management by a specialist paediatric anaesthetist compared with a registrar ( all p<0.0001 ) , and use of face mask compared with tracheal intubation ( all p<0.0001 ) . INTERPRETATION Children at high risk for perioperative respiratory adverse events could be systematic ally identified at the preanaesthetic assessment and thus can benefit from a specifically targeted anaesthesia management . FUNDING Department of Anaesthesia , Princess Margaret Hospital for Children , Swiss Foundation for Grants in Biology and Medicine , and the Voluntary Academic Society Basel BACKGROUND Pediatric dental procedures are increasingly performed under general anesthesia because of the inability to cooperate , situational anxiety , or other behavioral problems . Volatile anesthetics have been associated with emergence delirium in children , whereas the use of propofol for anesthetic maintenance has been shown to reduce the incidence of emergence delirium after other types of surgeries . The aim of this study is to compare a sevoflurane-based anesthetic with a propofol-based technique as it relates to the incidence of emergence delirium and the quality of recovery after pediatric dental surgery , in patients who present with risk factors for perioperative behavioral issues . METHODS We prospect ively collected data of 179 pediatric patients scheduled for ambulatory dental surgery using a double-blind and r and omized trial design . Subjects were anesthetized following st and ardized protocol s for either a sevoflurane- or a propofol-based technique . The incidence of emergency delirium , as measured by the Pediatric Anesthesia Emergence Delirium score , was the primary outcome . Secondary outcomes included the incidence of postoperative nausea and vomiting ( PONV ) , number of nursing interventions in the recovery room , time to discharge readiness , and parental satisfaction . RESULTS We found no difference in the incidence of emergence delirium after both types of anesthesia . However , use of sevoflurane significantly increased both the risk of PONV and the number of postoperative nursing interventions . Discharge criteria were met about 10 min earlier in patients anesthetized with sevoflurane .  Parental satisfaction was equally high with both anesthesia regimens . CONCLUSIONS A propofol-based anesthetic technique did not lead to a lower incidence of emergence delirium after dental surgery in children but did result in significantly less PONV and fewer postoperative nursing interventions This study was an authors comparison of the effects of and recovery from anesthesia in healthy , premedicated pediatric out patients who received either inhaled anesthetics ( group 1 ) or propofol ( group 2 ) . Group 1 ( n = 68 ) averaged 3.8 + /- 0.2 yr and weighed 17.7 + /- 0.8 kg , whereas group 2 ( n = 75 ) averaged 3.3 + /- 0.2 yr and weighed 16.3 + /- 0.6 kg . The incidence of vomiting in the Postanesthetic Care Unit ( PACU ) and from discharge to the first postoperative morning was lower in the group receiving propofol ( 0 % and 18 % ) than in the group receiving volatile agents ( 7 % and 34 % , P < 0.05 ) . The incidence of airway obstruction during induction of anesthesia was higher ( 34 % vs 10 % , P < 0.01 ) in children receiving inhaled agent .  Withdrawal of the extremity with propofol injection occurred in 14 ( 19 % ) patients . Arterial blood pressure was higher at loss of consciousness , laryngoscopy , and tracheal intubation in group 2 ( P < 0.01 ) . The length of time from the end of surgery to extubation of the trachea , recovery scores , and length of time spent in the PACU and the Day Surgery Unit were the same in the two groups . Pain scores obtained in the PACU were not different . The data indicate that propofol can be used safely to induce and maintain anesthesia in healthy pediatric out patients . This coupled with the low incidence of vomiting and airway obstruction in the propofol group suggests distinct and compelling reasons to consider using the drug in this patient population BACKGROUND Emergence delirium ( ED ) is a frequent postoperative complication in young children undergoing ENT procedures and it may be exacerbated by sevoflurane anesthesia whereas propofol maintenance has been suggested to decrease the incidence of ED . The aim of this r and omized , prospect i ve , double-blind study was to evaluate the effect of sevoflurane vs propofol anesthesia on the quality of recovery after adenotonsillectomy . METHODS Forty-two patients were r and omized to maintenance with either propofol or sevoflurane for adenotonsillectomy .  At the conclusion of surgery , patients were extubated awake . ED and pain were assessed using the Pediatric Anesthesia Emergence Delirium ( PAED ) and the Children 's Hospital of Eastern Ontario Scale ( CHEOPS ) , respectively . Higher PAED scores ( 0 - 20 ) indicate greater severity of ED . Nursing and parental satisfaction , hospital length of stay , postoperative nausea and vomiting ( PONV ) , anesthetic complications , and subsequent emergency room admissions were also assessed . RESULTS Median PAED score was 14 in the propofol group and 17 in the sevoflurane group ( NS ) . Propofol was associated with less pain medication required during recovery and a lower incidence of PONV ( 5.3 % vs 36.8 % , P < 0.05 ) . Nursing and parental satisfaction as well as 
    Output:
    
For the risk of PONV the results of the studies were conflicting , and for the risks of intraoperative and postoperative complications there were no significant differences between the groups .
There is insufficient evidence to determine whether intravenous anaesthesia with propofol for induction and maintenance of anaesthesia in paediatric out patients undergoing surgery reduces the risk of postoperative nausea and vomiting and the risk of behavioural disturbances compared with inhaled anaesthesia .