Anaesthetic quality in children during inhalational induction and anaesthesia with sevoflurane or halothane; [COCUKLARDA SEVOFLURAN ILE HALOTANIN ANESTEZI KALITESI YONUNDEN KARSILASTIRILMASI]
No Thumbnail Available
Date
1997
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
Due to its low blood gas partition coefficient (0.69) and its neutral odor, sevoflurane (S) is suitable for inhalational induction of anaesthesia. At the moment halothane (H) is preferentially used for this purpose due to its non-irritating odor and the smoothness of anaesthetic action. However, experience is limited with the use of S in children. Therefore, we compared S and H in an open, randomized trial. 40 children (age 1-10, mean, 5.3 years, ASA class I and II) had anaesthesia induced without premedication (fresh gas flow 6 L/min, N2O/O2=65/35). Concentration of volatile anaesthetics was increased ever 3-5 breats (S: % 0.8....3.2 vol, H: % 0.4....1.6 vol). The ciliary reflex was tested until it disappeared. Airway reflexes and excitation were quantified using a score. Upon venipuncture, relaxation and intubation, anaesthesia was maintained with S (Fi: % 1.8 vol) or H (Fi: % 0.9 vol) in N2O/O2 (3 L/min) E(T)CO2 35-38 mmHg). Alfentanyl was supplemented in repeated doses of 10 μg/kg, ECG, NIBP, SpO2, Fi and Fet of CO2 and volatile anaesthetics were continuously recorded. At the end of surgery anaesthetics were terminated abruptly and fresh gas flow was increased to 6 L/min O2. Time to the first purposeful movement was registered. Time to possible discharge from the PACU was quantified using a modified Aldrete score. Data were analysed with 'Student's t' test or non-parametric tests as appropriate. Groups did not differ with respect to age, weight, sex, or type of surgery. It's concluded that sevoflurane is an alternative to halothane in pediatric inhalational anaesthesia, with a comparable, low incidence of airway irritation and smoothness of induction. Because of the significantly faster induction and recovery it seems superior to halothane.