Comparison of sevoflurane concentration for insertion of proseal laryngeal mask airway and tracheal intubation in children (correlation with BIS)

Mudakanagoudar, Mahantesh S; Santhosh, M.C.B.

doi:10.1016/j.bjane.2014.07.011

Cited by 7 publications

(5 citation statements)

References 11 publications

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“…Such high numbers of downrolling were witnessed during induction in our study because in general, induction with sevoflurane is rapid (alveolar concentration approaches inspired concentration much more rapidly) and because its flow to lungs is generally kept high during induction. The mean concentration of sevoflurane during induction at which EDEM/EDEP occurred prior to LMA insertion was high (median MAC = 2.65; IQR 2.28-3.0) which matched with other studies (8). In children, where it is common to use a volatile induction, sevoflurane is the preferred choice.…”

Section: Timing Of Onset Of Down-rolling During Ga During Inductionsupporting

confidence: 75%

Tonic down-rolling and eccentric down-positioning of eyes under sevoflurane anesthesia without non-depolarizing muscle relaxant and its relationship with depth of anesthesia

et al. 2023

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PurposeTo analyze the relationship between eccentric downward eye movement/eccentric downward eye-positioning (EDEM/EDEP) encountered in patients undergoing ophthalmic surgeries and its return to a centralized position under general anesthesia (GA) with the depth of anesthesia (DOA).MethodsPatients undergoing ophthalmic surgeries (6 months-12 years) under sevoflurane anesthesia without non-depolarizing muscle relaxant (NDMR) who witnessed a sudden tonic EDEM/EDEP were both retrospectively (R-group) and prospectively (P-group) enrolled (ambispective study). R-group included data-points after induction (AI) till the time surgery lasted while P-group compiled data both during induction (DI) and AI. DOA in terms of MAC (minimum alveolar concentration) at the time of EDEM/EDEP and centralization of eyeball and their timings were noted and compared for both AI and DI data-points. Also, vertical eccentric eye positions were scored and correlated with MAC.ResultsAI data included 22 (14R+8P) events and their mean MAC of EDEM/EDEP and centralization were 1.60 ± 0.25 and 1.18 ± 0.17 respectively (p = 0.000). DI data included 62 (P) cases and its mean MAC of EDEM/EDEP and centralization was 2.19 ± 0.43 and 1.39 ± 0.26 respectively (p = 0.000). Median (IQR) eye positions during down-positioning in 84 events was −3 (−3.9 to −2.5). It was preceded by an eccentric upward drift of eyes in 10/22 (6R+4P) AI cases. A strong negative correlation was seen between DOA and eccentric eye positions (r = −0.77, p = 0.000).ConclusionsTonic down-rolling of eyes is not uncommon in children seen without NDMR with higher depths of sevoflurane anesthesia compared to point of centralization and fluctuations in DOA should be avoided to circumvent inadvertent complications during ocular surgery.

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Section: Timing Of Onset Of Down-rolling During Ga During Inductionsupporting

confidence: 75%

Tonic down-rolling and eccentric down-positioning of eyes under sevoflurane anesthesia without non-depolarizing muscle relaxant and its relationship with depth of anesthesia

et al. 2023

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“…Another potential risk expected was laryngospasm. We were able to avert this by maintaining adequate depth of anaesthesia with an ETS of 2.5 with 2 mcg/kg of fentanyl 11 12…”

Section: Discussionmentioning

confidence: 99%

Anaesthetic management of an infant with cleft palate lateral synechiae syndrome

Gayathri,

Venkatraman,

Murugan

et al. 2023

BMJ Case Rep

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An infant with restricted mouth opening from birth had presented for cleft lip repair. He had an interalveolar gap of 6 mm and was diagnosed as a case of cleft palate lateral synechiae syndrome. Fibreoptic bronchoscope of appropriate size was not available at the time of the procedure, and we had to device an alternative plan. The case describes the common challenges that can arise while anaesthetising infants with this syndrome in a resource-limited setting and highlights the importance of adapting the protocol to the demands.

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“…In addition, it is used to adjust the number of anesthetic agents administered and reduce the recovery time from general anesthesia [ 26 ]. Certain studies have shown that BIS monitoring during anesthesia aids the reduction of the sevoflurane requirement and results in more rapid emergence from general anesthesia [ 29 ]. Chan et al reported that the titration of an anesthetic to maintain a BIS value between 40 and 60 during surgery could be used to avoid episodes of deep anesthesia, which was associated with a reduction in the risk of developing delirium [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

The Effect of Propofol versus Sevoflurane on Postoperative Delirium in Parkinson’s Disease Patients Undergoing Deep Brain Stimulation Surgery: An Observational Study

Zhou

et al. 2022

Brain Sciences

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Background: The selection of the maintenance of general anesthesia may affect the development of postoperative delirium (POD), notably for Parkinson’s disease (PD) patients, due to their lower cognitive reserve. The present study was designed to compare the potential impact of propofol vs. sevoflurane based general anesthesia maintenance methods on the development of POD in PD patients following deep brain stimulation (DBS) surgery. Methods: A total of 125 PD patients who were scheduled to undergo DBS surgery were randomly divided into the propofol (n = 63) and the sevoflurane groups (n = 62). The patients in the two groups randomly received propofol- or sevoflurane-based general anesthesia. The Confusion Assessment Method (CAM) was employed by an investigator who was blinded to the anesthesia regimen and was administered twice per day from postoperative day 1 until discharge. Results: The incidence of POD was 22.22% (14/63) with propofol anesthesia and 20.97% (13/62) with sevoflurane anesthesia (p = 0.865). In addition, no difference was noted in the duration and severity of delirium between the propofol and sevoflurane groups. Conclusions: In the present study, propofol- and sevoflurane-based general anesthesia exhibited comparable results with regard to the POD incidence in PD patients undergoing deep brain stimulation surgery.

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Comparison of sevoflurane concentration for insertion of proseal laryngeal mask airway and tracheal intubation in children (correlation with BIS)

Abstract: We can conclude that in children airway can be secured safely with proseal laryngeal mask airway using less sevoflurane concentration in comparison to tracheal intubation and this was supported by BIS index.

Cited by 7 publications

References 11 publications

Tonic down-rolling and eccentric down-positioning of eyes under sevoflurane anesthesia without non-depolarizing muscle relaxant and its relationship with depth of anesthesia

Tonic down-rolling and eccentric down-positioning of eyes under sevoflurane anesthesia without non-depolarizing muscle relaxant and its relationship with depth of anesthesia

Anaesthetic management of an infant with cleft palate lateral synechiae syndrome

The Effect of Propofol versus Sevoflurane on Postoperative Delirium in Parkinson’s Disease Patients Undergoing Deep Brain Stimulation Surgery: An Observational Study

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