A Comparison of Sevoflurane with Halothane for Paediatric Day Case Surgery

Walker, Suellen M.; Haugen, Richard D.; Richards, A. Mark

doi:10.1177/0310057x9702500609

Cited by 56 publications

(29 citation statements)

References 16 publications

(26 reference statements)

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“…20 A similar model with isoflurane has not been evaluated, but isoflurane is known to irritate the upper airway in children. 16,21,22 Furthermore, we removed the LMA at a deep level of anesthesia, a maneuver that has been associated with fewer adverse airway events than its removal in the awake state. 16,23 This may have further decreased the difference in the rates of adverse airway events between the 2 treatments.…”

Section: Discussionmentioning

confidence: 99%

Propofol Anesthesia for Children Undergoing Magnetic Resonance Imaging

Heard¹,

Harutunians²,

Houck³

et al. 2015

Anesthesia &Amp; Analgesia

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Section: Discussionmentioning

confidence: 99%

Propofol Anesthesia for Children Undergoing Magnetic Resonance Imaging

Heard¹,

Harutunians²,

Houck³

et al. 2015

Anesthesia &Amp; Analgesia

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“…14 There is now some evidence that sevoflurane may be associated with even fewer airway complications such as laryngospasm and coughing than halothane. 15 If deepening anaesthesia fails and muscle relaxation is required, suxamethonium is the current agent of choice for its rapidity of both onset and offset. The dose required can be as little as 0.1 mg/kg IV.…”

Section: Discussionmentioning

confidence: 99%

Crisis management during anaesthesia: laryngospasm

Visvanathan

Kluger²,

Webb³

et al. 2005

Quality and Safety in Health Care

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Background: Laryngospasm is usually easily detected and managed, but may present atypically and/or be precipitated by factors which are not immediately recognised. If poorly managed, it has the potential to cause morbidity and mortality such as severe hypoxaemia, pulmonary aspiration, and post-obstructive pulmonary oedema. Objectives: To examine the role of a previously described core algorithm ''COVER ABCD-A SWIFT CHECK'', supplemented by a specific sub-algorithm for laryngospasm, in the management of laryngospasm occurring in association with anaesthesia. Methods: The potential performance of this structured approach for the relevant incidents amongst the first 4000 reported to the Australian Incident Monitoring Study (AIMS) was compared with the actual management as reported by the anaesthetists involved. Results: There were 189 reports of laryngospasm among the first 4000 incidents reported to AIMS. These were extracted and analysed. In 77% of cases laryngospasm was clinically obvious, but 14% presented as airway obstruction, 5% as regurgitation or vomiting, and 4% as desaturation. Most were precipitated by direct airway stimulation (airway manipulation, regurgitation, vomiting, or blood or secretions in the pharynx), but patient movement, surgical stimulus, irritant volatile agents, and failure to deliver the anaesthetic were also precipitating factors. Desaturation occurred in over 60% of cases, bradycardia in 6% (23% in patients aged ,1 year), pulmonary oedema in 4%, and pulmonary aspiration in 3%. It was considered that, correctly applied, the combined core algorithm and sub-algorithm recommended for the diagnosis and management of laryngospasm would have led to earlier recognition of the problem and/or better management in 16% of cases. Conclusion: Laryngospasm may present atypically and, if not promptly managed effectively, may lead to morbidity and mortality. Although usually promptly recognised and appropriately managed, the use of a structured approach is recommended. If such an approach had been used in the 189 reported incidents, earlier recognition and/or better management may have occurred in 16% of cases.

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“…In several studies, objective pain/discomfort scores during the first 30 to 40 minutes in the recovery room were significantly [74,88] or markedly (statistical analysis not reported) [81,83] higher in sevoflurane than in halothane recipients.…”

Section: Postoperative Painmentioning

confidence: 99%

“…In a few studies the times to induction [81,86] or emergence [82,87] were similar between treatment groups and 1 study found a longer time to recovery with sevoflurane. [89] …”

Section: Sevoflurane Versus Halothanementioning

confidence: 99%

“…Most of the numerous small trials conducted in ≤50 paediatric patients undergoing general [81][82][83][84][85][86] or ENT surgery [85,87,88] demonstrated significantly shorter [82,84,87,88] times to induction and faster [81,[83][84][85][86]88] times to recovery with sevoflurane compared with halothane. In a few studies the times to induction [81,86] or emergence [82,87] were similar between treatment groups and 1 study found a longer time to recovery with sevoflurane.…”

Section: Sevoflurane Versus Halothanementioning

confidence: 99%

See 1 more Smart Citation

Sevoflurane in Paediatric Anaesthesia

Goa¹,

Noble²,

Spencer³

1999

Pediatric Drugs

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Sevoflurane is a preferred anaesthetic agent for induction and maintenance of paediatric anaesthesia because of its rapid induction and recovery characteristics, lack of pungency and agreeable odour, and acceptable cardiovascular profile. Although the issue of postoperative excitement requires clarification, sevoflurane anaesthesia can be considered a rational choice for ambulatory and nonambulatory surgery in children.

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A Comparison of Sevoflurane with Halothane for Paediatric Day Case Surgery

Cited by 56 publications

References 16 publications

Propofol Anesthesia for Children Undergoing Magnetic Resonance Imaging

Propofol Anesthesia for Children Undergoing Magnetic Resonance Imaging

Crisis management during anaesthesia: laryngospasm

Sevoflurane in Paediatric Anaesthesia

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