Clinical Characteristics of Sevoflurane in Children

Sarner, J. B.; Levine, Mark; Davis, Peter J.; Lerman, Jerrold; Cook, David; Motoyama, Etsuro K.

doi:10.1097/00000542-199501000-00006

Cited by 259 publications

(148 citation statements)

References 32 publications

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“…Among the paediatric patients not receiving intraoperative analgesics, those maintained with sevoflurane required postoperative analgesics earlier than those who received halothane. The earlier time for extubation, requirement of analgesics and discharge readiness suggest that sevoflurane provided more rapid emergence and earlier awakening than halothane [4]. In a separate study sevoflurane was compared with propofol for induction and maintenance of anaesthesia [5].…”

Section: Discussionmentioning

confidence: 99%

Comparative Study of Recovery after Sevoflurane versus Halothane Anaesthesia in Adult Patients

Ravi¹,

Nanda²,

Anant³

2008

Medical Journal Armed Forces India

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Background: Induction and maintenance characteristics of sevoflurane and halothane have been studied, but little work has been done to compare the postoperative recovery of these two agents. Methods: Sixty adult, ASA I and II patients were allocated randomly into Group A and Group B of 30 each. Group A received sevoflurane and Group B received halothane for maintenance. At the end of surgery early recovery, intermediate recovery and discharge criteria were assessed. Results: Early recovery assessed with the mean time to extubation was 6.7 ± 2.29 min in Group A and 9.07 ± 1.64 min in Group B; eye opening was 7.28 ± 2.3 min in Group A and 10.6 ± 1.77 min in Group B; response to verbal command was 8.52 ± 2.83 min in Group A and 12.33 ± 2.17 min in Group B, while orientation was 10.43 ± 3.15 min in Group A and 14.77 ± 2.66 min in Group B. These differences were statistically significant (p<0.001).The mean time to reach post anaesthesia care unit discharge criteria was shorter for Group A (21.1 ± 4.69 min) as compared to Group B (27.43 ± 6.51 min) and this difference was statistically significant (p<0.001) Conclusion: Early recovery time and time taken to achieve discharge criteria were faster with sevoflurane. MJAFI 2008; 64 : 325-328

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Section: Discussionmentioning

confidence: 99%

Comparative Study of Recovery after Sevoflurane versus Halothane Anaesthesia in Adult Patients

Ravi¹,

Nanda²,

Anant³

2008

Medical Journal Armed Forces India

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“…Therefore, we adopted 2.5% halothane as the inspired concentration (2 MAC EI ) for the halothane group in this study. The haemodynamic responses to > 1 MAC sevoflurane in infants and children have not been quantified, although blood pressure and heart rate responses during inhalational induction with inspired concentrations up to 7% sevoflurane have been unremarkable [20,21]. While a vaporiser delivering 7% sevoflurane is widely used, high concentrations (> 5%) of sevoflurane were reported to possibly induce electroencephalographic evidence of seizure activity [12].…”

Section: Figurementioning

confidence: 99%

Anaesthetic induction time for tracheal intubation using sevoflurane or halothane in children

et al. 1998

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SummaryThe current study was designed to determine the anaesthetic induction time required for tracheal intubation (Time EI ) with equipotent inspired concentrations of 5% sevoflurane and 2.5% halothane in oxygen. Time EI that prevents 50% and 95% of patients from coughing and gross purposeful muscular movements after intubation was defined as Time EI 50 and Time EI 95, respectively. Thirtysix patients aged 1-7 years were enrolled in the study. Anaesthesia was induced via mask and when Time EI attained a predetermined value, intubation was performed using an uncuffed tube. Each Time EI at which tracheal intubation was attempted was predetermined according to the up-anddown method. When intubation was accomplished without gross purposeful muscular movements, it was considered a smooth intubation. Determination with this method revealed that Time EI 50 and Time EI 95 for the sevoflurane/halothane groups were 147/214 s and 194/255 s, respectively. In conclusion, it is possible to determine Time EI using an inspired sevoflurane concentration of 5% and halothane 2.5% in oxygen. The technique with 5% sevoflurane seems more practical for paediatric anaesthesia induction in busy clinical situations. Although halothane has been used as the main drug for inhalational induction of anaesthesia in children, sevoflurane has several theoretical advantages over halothane. Sevoflurane has fewer myocardial depressant effects than halothane [1], and it is less extensively metabolised [2]. Additionally, sevoflurane has a lower solubility in blood [3] and a pleasant smell [2, 4-6] permitting smooth induction and tracheal intubation without neuromuscular blockade [7,8]. Moveover, sevoflurane would be expected to produce a more rapid anaesthetic induction for tracheal intubation than halothane. End-tidal concentrations of sevoflurane and halothane at which a smooth intubation is possible in 50% of patients have been designated as minimum alveolar concentration required for (endo)tracheal intubation (MAC EI ) [7,9]. In the conventional method to determine MAC EI , a predetermined end-tidal concentration of inhaled anaesthetic needs to be maintained at a constant level for at least 15 min to establish equilibration among cerebral, arterial blood and alveolar gas tensions before tracheal intubation is attempted [7][8][9][10][11]. This conventional method may not be practical for tracheal intubation in children. To our knowledge, there has been no detailed study of minimum anaesthetic induction time required for tracheal intubation using inhalational anaesthetics without neuromuscular relaxants. Moreover, the use of an overpressure technique to achieve MAC EI within a clinically acceptable time is limited by reports that high concentrations (> 5%) of sevoflurane may induce electroencephalographic evidence of seizure activity [12]. The aim of the current study, therefore, was to determine the anaesthetic induction time required for tracheal intubation (Time EI ) with equipotent inspired concentrations (Ϸ 2 MAC EI ) [7,9] of 5% sevoflurane ...

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“…The elevation of the ETsev concentration in a shorter time with the addition of nitrous oxide gave us the impression that indirectly, the anesthetic concentration in the brain had also risen more rapidly. Also, Sarner et al (11), in their study, determined that the duration for the ETsev to reach a concentration of 2% was reduced significantly in the N 2 O-added group.…”

Section: Discussionmentioning

confidence: 90%

“…Those who defend that it shortens the induction period have suggested that N 2 O accomplishes this by the second gas effect and the previously shown additive effects (11,18,19,30). The opponent group has advocated in their studies that N 2 O does not shorten the induction period and the addition of N 2 O during induction is unnecessary (9,10,22).…”

Section: Discussionmentioning

confidence: 98%

Nitrous Oxide Effects the Uptake of Sevoflurane to the Body During Induction

Erel¹,

Gürsoy²,

Kurt³

et al. 2018

meandros

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ÖzAmaç: İnhalasyon indüksiyonu sırasında azot protoksit gazının (N 2 O) sevofluranın vücuda alınması sürecinin hızı ve kalitesi üzerindeki etkilerini araştırmaktır. Gereç ve Yöntemler: Jinekolojik müdahale yapılması planlanan Amerikan Anestezistler Derneği kriterlerine göre I-II grubunda 84 kadın hasta randomize edilerek iki gruba ayrıldı. Tek soluk indüksiyonu yöntemi ile anestetize edilen hastalarda birinci gruba [Grup sevoflurane and azot protoksit (SA)] indüksiyonda %8 sevofluran, %67 azot protoksit ve %33 oksijen, ikinci gruba [Grup sevofluran (S) ve azot protoksit] %8 sevofluran ve %100 oksijen uygulandı. İndüksiyon sırasında oksijen, karbondioksit ve sevofluranın end-tidal ve inspiratuvar yoğunlukları, kirpik refleksinin kaybolmasına kadar geçen süre, gözlerin orta hatta gelmesi AbstractObjective: To determine the effects of nitrous oxide (N 2 O) on the speed and quality of the uptake process of sevoflurane during inhalation induction in adult patients. Materials and Methods: For randomized controlled study, eighty-four American Society of Anesthesiologists I-II patients undergoing gynecological interventions were randomly assigned to receive an 8% sevoflurane mixture with either 67% N 2 O plus 33% oxygen [Group sevoflurane and nitrous oxide (SA)] or 100% oxygen only [Group sevoflurane (S)]. Both groups were induced by a single-breath induction. End-tidal and inspiratory concentrations of respiratory and anesthetic gasses were continuously assessed during induction as well as time to loss of eyelash reflex, time to cessation of eye movements, and time to initiation of spontaneous breaths. Patients were intubated by the 5 th minute of induction and their vital signs, bispectral indexes, reflex responses to intubation and additional drug requirements for intubation were also recorded. Results: End-tidal sevoflurane concentrations and the ratio of alveolar to inspiratory sevoflurane concentrations (F A /F i ) of patients in group SA recorded at the 2 nd , the third and the 5 th minute of induction showed statistically significant increases when compared with patients in group S. Time to loss of eyelash reflex and time to cessation of eye movements were found to be decreased in group SA by 25 and 13%, respectively. Patients who presented with a reflex response to intubation in group S exceeded patients in group SA by 38.8% and patients who required additional medication for intubation in group S exceeded patients in group SA by 28.6%. Conclusion: The findings of this study support the view that administration of N 2 O improves the rate and quality of mask induction with sevoflurane. The benefits provided by N 2 O attributable to the concentrating and second gas effects appear during the first few minutes of induction (2 nd , 3 rd , and 4 th minutes) as well as during intubation when sevoflurane is used for mask induction.

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Clinical Characteristics of Sevoflurane in Children

Cited by 259 publications

References 32 publications

Comparative Study of Recovery after Sevoflurane versus Halothane Anaesthesia in Adult Patients

Comparative Study of Recovery after Sevoflurane versus Halothane Anaesthesia in Adult Patients

Anaesthetic induction time for tracheal intubation using sevoflurane or halothane in children

Nitrous Oxide Effects the Uptake of Sevoflurane to the Body During Induction

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