Tehran University of Medical Sciences Journal of Pharmaceutical Care 2322-4630 6 1-2 2018 12 12 23 28 Amir Shafa Department of Anesthesiology, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran Mohammadreza Habibzadeh Department of Anesthesiology, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran Behnaz Seydmohammadi Department of Anesthesiology, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran 2018 11 17 2018 11 20 Background: Cleft palate repair is associated with hemorrhage and hemodynamic changes in children. This study aimed to compare hemodynamic changes during cleft palate repair in patients anesthetized with isoflurane-remifentanil and propofol-remifentanil. Methods: In this randomized, double blind study, 100 cleft palate repair candidates who aged under three years were allocated to two groups of 50 to receive either isoflurane-remifentanil or propofol-remifentanil for maintaining anesthesia.   Results: The mean systolic and diastolic blood pressure and the mean arterial pressure were significantly lower in the propofol-remifentanil group (P < 0.001). The mean extubation time (P < 0.001), time to first analgesic administration (P = 0.04), and recovery time (P < 0.001) were significantly longer in the isoflurane-remifentanil group. Conclusion: Propofol-remifentanil-based anesthesia caused more stable hemodynamic state in patients undergoing cleft palate repair. The mean systolic and diastolic blood pressure, as well as the mean arterial pressure, were lower with propofol-remifentanil administration. Therefore, this combination can lower the risk of intraoperative hemorrhage.   https://jpc.tums.ac.ir/index.php/jpc/article/view/233 https://jpc.tums.ac.ir/index.php/jpc/article/download/233/178