High initial concentration versus low initial concentration sevoflurane for inhalational induction of anaesthesia

Boonmak, Polpun; Boonmak, Suhattaya; Pattanittum, Porjai

doi:10.1002/14651858.cd006837.pub3

Cited by 14 publications

(10 citation statements)

References 48 publications

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“…At 10 min after intubation, in the SIPFR group, HR was lower than the HR of IVCIS group patients, nonetheless within normal range limits. These findings agree with the results of other studies on HR variation during sevoflurane administration, showing that by increasing sevoflurane concentration, the heart rate increases [ 15 - 16 ]. The increase in heart rate during laryngoscopy was greater in group IVCIS patients.…”

Section: Discussionsupporting

confidence: 92%

Propofol/Fentanyl/Rocuronium or Sevoflurane Inhalational Induction for Intubation?

Mitos¹,

Thoma²,

Tsaousi³

2021

Cureus

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Introduction Anesthesia induction and airway instrumentation are critical parts of anesthesia administration. Intravenous induction is time convenient but necessitates immediate commencement of ventilation. Inhalational sevoflurane induction takes longer but preserves spontaneous respiration. The primary aim of this study is to evaluate the intubation quality features achieved by sevoflurane as the sole induction agent compared with the standard intravenous induction, involving the use of muscle relaxants. Methods Sixty patients were randomly allocated into two groups: the Inhalational Vital Capacity Induction With Sevoflurane (IVCIS) group (n = 30) in which patients were intubated after sevoflurane inhalational anesthesia with the vital capacity technique and the Standard Intravenous Induction With Propofol, Fentanyl, and Rocuronium (SIPFR) group (n = 30) after propofol 1.5 mg/kg, fentanyl 2 μg/kg, and rocuronium 0.5 mg/kg administration intravenously. Group IVCIS patients were intubated when bispectral index (BIS) < 60 and end-expiratory sevoflurane ≥ 2 minimum alveolar concentration for > eight minutes. Scoring systems were used to evaluate induction and intubation conditions. The Statistical Package for the Social Sciences (SPSS) software version 25.0 (IBM Corp., Armonk, NY) was used for data analysis. Results Intubating and induction conditions were of equal quality in both groups. Sevoflurane induction duration was markedly prolonged. Heart rate was higher in IVCIS group patients throughout the induction, especially during laryngoscopy. Less blood pressure fluctuations were recorded in IVCIS group patients. Conclusions Inhalational vital capacity induction with sevoflurane provided acceptable intubating conditions and exhibited a safe hemodynamic profile, albeit the duration was more than 12 minutes.

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Section: Discussionsupporting

confidence: 92%

Propofol/Fentanyl/Rocuronium or Sevoflurane Inhalational Induction for Intubation?

Mitos¹,

Thoma²,

Tsaousi³

2021

Cureus

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“…The decision of the method of induction will therefore be patient-and anesthesiologist-dependent after a balance of the risks and benefits in each specific situation [24]. When proceeding with an inhalational induction, there is suggestion that the induction time can be shortened using a higher initial concentration of sevoflurane, with no significant increase in undesirable effects such as cough, laryngospasm, or breath holding [25]. A tight seal with the facemask and avoiding high gas flows may be beneficial to minimize any exposure to personnel in the room.…”

Section: The Induction Of General Anesthesia In Childrenmentioning

confidence: 99%

Unique challenges in pediatric anesthesia created by COVID-19

2020

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Coronavirus disease 2019 (COVID-19) has affected anesthetic care worldwide, including the provision of anesthesia for pediatric patients. Hospitals have balanced the risks associated with the potential surges of resource-intensive COVID-19 patients against the probable morbidity of delaying elective surgical procedures. These decisions are complicated by the unclear influence that COVID-19 has on the perioperative risk for disease-positive pediatric patients. We conducted a comprehensive literature search on MEDLINE for publications involving pediatric patients with COVID-19 who underwent general anesthesia. A total of eight publications met inclusion criteria, and together described 20 patients. Nine patients had documented preoperative COVID-19 symptoms and one perioperative death was reported. Overall, further studies are needed to increase patient numbers and properly assess the perioperative risk. As we continue to provide care without clear guiding data, we present a discussion of modified anesthetic techniques for pediatric patients with suspected or confirmed COVID-19.

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“…A Cochrane review showed that a high initial concentration sevoflurane technique results in a more rapid induction of anaesthesia with a similar rate of complications as the incremental technique, with the exception of apnoea which is more common with high initial concentration. [29]…”

Section: Induction Of Anaesthesiamentioning

confidence: 99%

Premedication and induction of anaesthesia in paediatric patients

Dave

2019

Indian J Anaesth

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Perioperative anxiety has been associated with adverse clinical outcomes such as emergence delirium, increased analgesic requirements and negative postoperative behavioural changes such as sleep disturbance, separation anxiety, eating problems and new-onset enuresis. Predictors of preoperative anxiety have been identified, and these include, among other factors, the age and temperament of the child. Any plan for anaesthetic induction in a child must take into account these factors. The anaesthetic plan must be individualised for special situations, for example, the child with behavioural disorder or at risk of aspiration. This article details the pharmacological and nonpharmacological methods to minimise preoperative anxiety and the techniques of anaesthetic induction in infants and children undergoing surgery. The benefits and limitations of inhalational and intravenous induction and the current status of rapid sequence induction in children are discussed. MEDLINE database was searched for this narrative review using the keywords including preoperative anxiety, child, premedication, paediatric and anaesthetic induction. Search was restricted to articles in English, but without any publication date restrictions.

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High initial concentration versus low initial concentration sevoflurane for inhalational induction of anaesthesia

Cited by 14 publications

References 48 publications

Propofol/Fentanyl/Rocuronium or Sevoflurane Inhalational Induction for Intubation?

Propofol/Fentanyl/Rocuronium or Sevoflurane Inhalational Induction for Intubation?

Unique challenges in pediatric anesthesia created by COVID-19

Premedication and induction of anaesthesia in paediatric patients

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