Optimum time for intravenous cannulation after induction with sevoflurane, oxygen, and nitrous oxide in children without any premedication

Kamrul-Hasan, A B; Sivasankar, Raman; Nair, Salil G.; Hasan, Wamia U.; Latif, Zulaidi

doi:10.1111/pan.13308

Cited by 8 publications

(21 citation statements)

References 14 publications

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“…Hasan et al studied the optimum time for intravenous cannulation after induction with sevoflurane, oxygen, and nitrous oxide in children aged 2-6 years undergoing elective dental surgery without application of any premedication 4 . Although their work differs from the present study in terms of nitrogen oxide use, similar to our study results (104.9 s), a 105 seconds of waiting time was recommended by the authors for the start of optimal intravenous access.…”

Section: Discussionmentioning

confidence: 99%

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Investigation of the Optimum Time for Intravenous Access After Anesthesia Induction with Sevoflurane in Pediatric Patients Without Premedication

Orhon

2020

MMJ

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Objective: Anesthesia induction is usually achieved with sevoflurane for pediatric patients without vascular access. The aim of this study was to investigate the optimum intravenous access time and to evaluate the corresponding bispectral index (BIS) value in pediatric patients after sevoflurane induction. Method: This prospective study included 100 children enrolled between January 1, 2017 and January 1, 2018 at Istanbul Medeniyet University Goztepe Training and Research Hospital. Anesthesia was induced with 8% sevoflurane and oxygen. Measurements included mask adaptation time, time to loss of the ciliary reflex, time to recovery of regular breathing, and optimal timing of intravenous access time with the corresponding BIS values, as well as the time elapsed for the BIS value to fall below 60. Results: The mean mask adaptation time was 27.8±28.4 s, time to loss of the ciliary reflex was 39.7±10.3 s, and time to reach regular respiration was 88.5±116.9 s, with mean BIS value of 80.4±16.9, 70.2±10.4, and 52.4±12.1, respectively. The mean time for BIS to fall below 60 was 72.54±24.41 s. The mean time required for the the iniation of optimal intravenous access was 104.92±36.45 s, with a mean BIS value of 30±10.1. Conclusion: Following anesthesia induction with sevoflurane in children, the BIS value below 60 which is the upper limit for surgical anesthesia, was found to be insufficient for intravenous intervention. For pediatric patients undergoing sevoflurane induction it has been concluded that, the BIS value below 30 or an average waiting time of 104.9 s is ideal for initiation of optimal intravenous access.

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Section: Discussionmentioning

confidence: 99%

“…Limited data are available in the literature regarding intravenous access time after anesthesia induction [3][4][5] . There is only one study investigating the BIS value at optimum intravenous access time 3 .…”

Section: Introductionmentioning

confidence: 99%

Investigation of the Optimum Time for Intravenous Access After Anesthesia Induction with Sevoflurane in Pediatric Patients Without Premedication

Orhon

2020

MMJ

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“…Literature was searched and we found that in most of studies optimum time for intravenous cannulation was documented . In majority of these studies high concentration of inhalational agent (4%–8%) was maintained for sufficiently long duration before attempting IV cannulation.…”

Section: Discussionmentioning

confidence: 99%

Sevoflurane EC50 for intravenous cannulation attempt and movement in children

Goel

Jain

Ghai

2019

Acta Anaesthesiol Scand

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Background: Intravenous cannulation at lighter planes of anaesthesia can lead to adverse respiratory and haemodynamic events. So far, there is no consensus on optimum end tidal sevoflurane concentration required for intravenous cannulation in children. We aimed to evaluate the optimum end tidal concentration at which an intravenous cannulation can be successfully attempted without movements in paediatric patients after inhalational induction of general anaesthesia. Material and Methods:In this clinical trial, paediatric subjects of either sex aged 1-3 years, weighing 7-15 kg having American Society of Anaesthesiologists physical status I/II of undergoing elective cataract surgery were included. After inhalational induction of general anaesthesia with 8% sevoflurane and 100% oxygen, end tidal sevoflurane concentration was maintained at 2% for 4 minutes for the first child. This was followed by intravenous cannulation attempted by an experienced anesthesiologist. The intravenous cannulation was considered to be unsuccessful if there was "movement" and successful if there was "no movement" in response to the stimuli of cannulation. End-tidal concentration was increased/decreased (step-size 0.2% for sevoflurane) using Dixon and Massey up and down method in the next patient depending upon previous patient's response. Results:The sevoflurane EC50 for successful intravenous cannulation is 1.32% ± 1.0%.Pearson correlation (r) between weight of the child and response to intravenous cannulation was found to be 0.40 with P value of 0.008. Conclusion:Intravenous cannulation can be accomplished without movements at end tidal sevoflurane of 1.3% in children aged 1-3 years in 50% of children.

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“…The induction of anesthesia using sevo urane is a widely used technique in pediatric patients as it eliminates issues such as fear of needles, body movement and the pain associated with intravenous cannulation. [1][2][3] Nitrous oxide is used with sevo urane and oxygen in order to achieve faster loss of consciousness and reduced excitatory movements. [2,3] Anesthesiologists have relied on clinical parameters such as the loss of eyelash re ex, heart rate and centralization of pupils to obtain the intravenous cannulation.…”

Section: Introductionmentioning

confidence: 99%

“…[4,5] Too early attempts to place an intravenous route immediately after the loss of consciousness may result in patient movement or respiratory complications such as laryngospasm and desaturation. [2,6,7] The developmental disabilities refer to a class of functional disorders in which affected persons require assistance, either mental or psychological. [8,9] They commonly have cognitive impairments due to developmental delays or disorders such as cerebral palsy, epilepsy and autism.…”

Section: Introductionmentioning

confidence: 99%

Sevoflurane concentration for cannulation in developmental disabilities

Kunihiro

Tsukamoto

Taura

et al. 2022

Preprint

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Objective: The goal of this study was to compare the end-tidal sevoflurane concentration and time for intravenous cannulation at induction of anesthesia using sevoflurane with or without nitrous oxide in healthy children and in those with developmental disabilities. Methods: Normal and developmentally disabled children were anesthetized by inhalation of sevoflurane with nitrous oxide or with nitrous oxide-free oxygen, and intravenous cannulae were introduced. The following parameters were recorded for each patient: age, sex, height, weight, BMI, duration of intravenous cannulation, intertidal concentration of sevoflurane at the completion of intravenous cannulation, and use of nitrous oxide. Two-way ANOVA was used for statistical evaluation of the experimental data. All values were expressed as mean ± standard deviation (SD) or number (n). p-values below 0.001 were considered statistically significant (two-way ANOVA). Results: In healthy children, the end-tidal sevoflurane concentrations at the completion of the intravenous cannulation showed a significant difference between when nitrous oxide was used (4.1 ± 0.8 %) and when nitrous oxide was not used (5.1 ± 1.1 %) (p<0.001). Also, in children with developmental disabilities, the end-tidal sevoflurane concentrations at intravenous cannulation showed a significant difference between when nitrous oxide was used (4.2 ± 0.9 %) and when nitrous oxide was not used (4.9 ± 1.3 %) (p<0.001). However, there was no significant difference in the time required for intravenous cannulation from the start of anesthesia induction in either group. Conclusions：Between the healthy children and the children with developmental disabilities, no significant differences in the end-tidal sevoflurane concentrations at the completion of the intravenous cannulation and the time for the intravenous cannulation from the beginning of anesthetic induction.

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Optimum time for intravenous cannulation after induction with sevoflurane, oxygen, and nitrous oxide in children without any premedication

Abstract: We recommend waiting for 1 minute 45 seconds (105 seconds) after the loss of eyelash reflex before attempting intravenous cannulation in pediatric patients induced with sevoflurane, oxygen, and nitrous oxide without any premedication.

Cited by 8 publications

References 14 publications

Investigation of the Optimum Time for Intravenous Access After Anesthesia Induction with Sevoflurane in Pediatric Patients Without Premedication

Investigation of the Optimum Time for Intravenous Access After Anesthesia Induction with Sevoflurane in Pediatric Patients Without Premedication

Sevoflurane EC50 for intravenous cannulation attempt and movement in children

Sevoflurane concentration for cannulation in developmental disabilities

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