The study failed to show any evidence of benefit of ketamine to improve analgesia in children when given in addition to a multimodal analgesic therapy with paracetamol, a NSAID and an opiate.

Rapid anesthesia induction using a single-breath technique with 7% sevoflurane is effective and well tolerated in children, particularly in those above 9 years of age, and in fact, success rate was markedly lower in the young age groups.

SummaryThe single-breath vital capacity technique is suitable for inhalation induction of anaesthesia, using sevoflurane in children aged > 5 years. The purpose of this randomised trial was to compare the single breath vital capacity technique with the conventional tidal volume technique. Seventy-three ASA 1 or 2 children were instructed during the pre-operative visit in the vital capacity technique. The main criterion measured was time to loss of the eyelash reflex. Induction was performed using a circle-absorber breathing circuit primed with sevoflurane 7% in 50% nitrous oxide 1 ⁄ oxygen with 6 l.min )1 fresh gas flow. Time required for induction, haemodynamic changes, airway tolerance and side-effects were recorded. The children's opinion on the technique used was scored using a visual analogue scale (0-100) and a Smiley scale (0-10). The time to loss of the eyelash reflex was found to be reduced in the vital capacity group compared to the tidal volume group. The time to central myosis, to achieve bispectral index values 60 and 40, haemodynamic changes, respiratory events and side-effect incidences were similar in both groups. However, we found that the vital capacity technique was preferred by the children to the tidal volume technique.

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