Comparison of sevoflurane and halothane for outpatient dental anaesthesia in children

Abstract

In a prospective, randomized, double-blind clinical study, we have studied 100 children, aged 2-12 yr, to compare halothane and sevoflurane in outpatient dental anaesthesia. All patients were unpremedicated and received inhalation induction using nitrous oxide in oxygen supplemented with either halothane (maximum inspired concentration 5%) or sevoflurane (maximum inspired concentration 8%). Time to loss of the eyelash reflex was more rapid using sevoflurane although time to adequate anaesthesia (to allow insertion of a mouth prop) was slower in the sevoflurane group. The incidence of cardiac arrhythmia was higher during halothane (62%) than during sevoflurane anaesthesia (28%) (P < 0.005) and the arrhythmias were more often ventricular in origin. The two agents were comparable in terms of ease of use and quality of anaesthesia, and times to eye opening and satisfying discharge criteria were similar. We conclude that sevoflurane has qualities that have made halothane the most used inhalation agent for children, and that it is superior to halothane in dental outpatients where cardiac arrhythmias are a particular problem.

The reinforced laryngeal mask in paediatric outpatient dental surgery

“…Arrhythmias are not uncommon during dental anaesthesia [13][14][15]. We frequently saw ventricular ectopics, the causes of which may be catecholamines, halothane or hypercarbia.…”

“…The greater number of episodes of arrhythmia in the nasal mask group may be due to the higher incidence of airway obstruction with consequent hypoxaemia and hypercarbia. The use of sevoflurane instead of halothane for induction and maintenance of anaesthesia has been shown to decrease the incidence of arrhythmias in paediatric dental surgery [15]. We used halothane because sevoflurane had not been licensed for use in Singapore at the time.…”

Comparison of Sevoflurane With Halothane for Endotracheal Intubation in Paediatric Patients

“…Meretoja O A et al (1996), 3 Paris S T et al (1997), 4 Brain K O et al (1998), 5 Sigston P E et al (1997), 6 Black A et al (1996), 7 and Vernoque et al (1994) 8 have used Sevoflurane and Halothane in paediatric patients for endotracheal intubation. In the present study, the age range was 3 months to 3 years and the age range of above authors was corresponding to our study.…”

“…We observed Sevoflurane to be more cardio stable as compared to Halothane as far as mean pulse rate was concerned. Paris S T et al (1993), 4 Brien K O, et al (1998), 5 Friesen R H et al (1982), 13 Veronique et al (1994), 8 and Sorner J B et al (1995) 11 have also noted Sevoflurane to be cardio stable during intubation than Halothane. Our observations correlate with these authors.…”

“…Meretoja O A et al (1996), 3 Paris S T et al (1997), 4 Brien K O et al (1998), 5 Massakki et al (1993), 9 Veronique et al (1994), 8 Matsuyki et al (1993), 10 Joel B et al (1995), 11 Sigston et al (1997), 6 Bkack A et al (1996), 7 and many others have used various inhalational anaesthetic agents such as Sevoflurane, Halothane, Enflurane, or Isoflurane for induction of anaesthesia in their paediatric patients. Many of them have noted that, induction time within 120-160 seconds for Sevoflurane and 180-240 secs for Halothane.…”