Age and Solubility of Volatile Anesthetics in Blood

Lerman, Jerrold; Gregory, G. A.; Willis, M. M.; Eger, Edmond I.

doi:10.1097/00132586-198510000-00050

Cited by 14 publications

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“…However, because the alveolar concentration of volatile anaesthetics increases more rapidly in children than in adults [18,19], it may be possible to determine the end-tidal concentration of sevoflurane for tracheal intubation more rapidly by using 5% inspired sevoflurane concentrations. In a busy clinical setting, this rapid technique may have practical advantages.…”

Section: Resultsmentioning

confidence: 99%

The optimal dose of remifentanil for intubation during sevoflurane induction without neuromuscular blockade in children

et al. 2007

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SummaryThe optimal dose of remifentanil needed to produce successful intubating conditions following inhalation induction of anaesthesia using 5% sevoflurane without the use of neuromuscular blocking drugs, was investigated in 25 children aged 3-10 years. Sixty seconds after inhalation induction of anaesthesia using sevoflurane 5% in 100% oxygen, a predetermined dose of remifentanil was injected over 30 s. The dose of remifentanil was determined using the modified Dixon's up-and-down method (0.2 lg.kg )1 as a step size). The first patient was tested at 1.0 lg.kgremifentanil. Ninety seconds following the bolus administration of remifentanil, the child's trachea was intubated. The optimal bolus dose of remifentanil required for successful tracheal intubation was 0.56 (0.15) lg.kg )1 in 50% of children during inhalation induction using 5% sevoflurane in the absence of neuromuscular blocking drugs. Using probit analysis, the 95% effective dose (ED 95 ) of remifentanil was 0.75 lg.kg )1 (95% confidence limits 0.63-1.38 lg.kg )1 ).

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Section: Resultsmentioning

confidence: 99%

The optimal dose of remifentanil for intubation during sevoflurane induction without neuromuscular blockade in children

et al. 2007

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“…Age is an important determinant of the increase in F A /F I ratio of halothane in infants and children and it has been reported that the increase in F A /F I ratio of halothane in infants and children is more rapid than in adults [17]. This difference has been attributed to four factors: greater alveolar ventilation; greater cardiac output directed to the vessel-rich group; lower tissue solubility [18]; lower blood solubility [19]. Although the increase in F A /F I ratio of sevoflurane in infants and children has not been reported, the rate of change of the ratio may be predicted using the four factors listed above.…”

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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“…Age effects on the blood/air partition coefficients of some lipophilic chemicals were also found in previous studies. For example, the blood/air partition coefficients of highly soluble inhaled anesthetics, including halothane and methoxyflurane, were significantly higher in adults than in children (27). These demographic effects were assumed to result indirectly from differences in the blood constituents.…”

Section: Discussionmentioning

confidence: 99%

Association of the blood/air partition coefficient of 1,3-butadiene with blood lipids and albumin.

Lin¹,

Smith²,

Wypij³

et al. 2002

Environ Health Perspect

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Pulmonary gas uptake is a function of the blood solubility of a vapor, indicated by the blood/air partition coefficient. We hypothesized that blood lipid compositions are associated with the blood/air partition coefficients of lipophilic toxic vapors such as 1,3-butadiene. Our goal was to investigate cross-sectional and longitudinal relationships of blood triglycerides, total cholesterol, and albumin to the blood/air partition coefficient of butadiene. We collected blood samples from 24 subjects at three time points: a fasting baseline and 2 and 4 hr after drinking a standardized high-fat milk shake (107 g fat, 80 g sugar, and 27 g protein). The blood/air partition coefficient was determined using the closed vial-equilibrium technique. Triglycerides and total cholesterol were analyzed by an enzymatic method, and albumin was analyzed with an immunoassay technique. We used multiple linear regression and general linear models to examine the cross-sectional and longitudinal relationship, respectively. The results showed that the blood/air partition coefficient of butadiene was cross-sectionally associated only with triglycerides at baseline, and longitudinally related to baseline triglycerides, total cholesterol, and the change in triglycerides over time. The blood/air partition coefficient of butadiene increased, on average, by approximately 20% and up to 40% for subjects with borderline higher triglyceride levels after ingestion of a standardized milk shake. In addition, a time factor beyond lipids was also significant in predicting the blood/air partition coefficient of butadiene. This may represent the effects of other unmeasured parameters related to time or time of day on the blood/air partition coefficient of butadiene. Because the blood/air partition coefficient is a major determinant of gas uptake, ingestion of a high fat meal before this type of exposure may significantly increase an individual's absorbed dose, possibly increasing the risk of adverse effects.

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Age and Solubility of Volatile Anesthetics in Blood

Cited by 14 publications

References 0 publications

The optimal dose of remifentanil for intubation during sevoflurane induction without neuromuscular blockade in children

The optimal dose of remifentanil for intubation during sevoflurane induction without neuromuscular blockade in children

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

Association of the blood/air partition coefficient of 1,3-butadiene with blood lipids and albumin.

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