Multiple-deep-breath inhalation induction with 5% sevoflurane and 67% nitrous oxide followed by the same inhalational anesthetics for maintenance was safely performed without serious adverse events. However, the induction time was shorter and patient satisfaction was higher in propofol group than in the inhalational group.
This study examined induction and recovery times and respiratory and cardiovascular changes during induction and recovery in paediatric patients undergoing anaesthesia under spontaneous respiration induced with sevoflurane (S group, n = 10) and halothane (H group, n = 9) at 2.4 MAC. FET/FI increased more rapidly, the incidence of breath holding and coughing was less and the recovery time was shorter in the S group compared with the H group. During induction with sevoflurane at 2.4 MAC, min vol/bodyweight decreased due to reduced tidal vol/bodyweight despite increased respiratory frequency, as with halothane at the same MAC. Slight decrease in blood pressure was observed during induction in the S group, while the circulatory depression was not observed during induction in the H group. These results suggest that sevoflurane is a suitable agent for induction under spontaneous respiration with higher concentrations in paediatric anaesthesia.
Summa yThe trigger sensitivity for pressure support ventilation (PSV) with a Servo 300 ventilator was evaluated in a 6-month-old male infant ventilated with synchronized intermittent mandatory ventilation (SIMV) of 14 c.min-' and PSV of 4 cmH20. The delay time between onset of inspiration and the trigger signal was 42 and 139 msec for trigger sensitivity of -2 and -4 cmH20, respectively. On the former sensitivity, the inspiration was sensed by a decrease of expiratory bias flow before the airway pressure decreased to the set level. The time between the trigger signal and the flow delivery was 7 msec. The supplied volume exceeded the spontaneous breath on both trigger sensitivities. Using Servo 300, the constant expiratory bias flow, the use of a flow trigger and the mechanical improvement of the inspiratory valve contribute to reduced delay time in the trigger function, making the ventilator well suited, set in the PSV mode, even at high spontaneous respiratory rates for infants.
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