Induction, maintenance and recovery characteristics of desflurane in infants and children

Taylor, Robert H.; Lerman, Jerrold

doi:10.1007/bf03008665

Cited by 103 publications

(41 citation statements)

References 30 publications

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“…The anaesthetist's experience with the agent did not affect the incidence of airway problems, which was similar (50%) throughout the study. The use of premedication or nitrous oxide in previous studies did not affect the incidence of airway complications Taylor & Lerman 1992). In our study the depth of anaesthesia did affect the incidence of airway problems.…”

Section: Discussionmentioning

confidence: 52%

Desflurane in paediatric anaesthesia

Mannion

Casey

Doherty

1994

Pediatric Anesthesia

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Summa yDespite the low blood-gas coefficient of desflurane, inhalational induction is deIayed by airway complications in paediatric practice. A slow induction technique reduces airway complications in adults. The aim of this study was to examine the use of desflurane for paediatric anaesthesia and to reduce airway complications with a slow induction technique. Sixty children (age range, 1 month to 12 years) were anaesthetized with 3% desflurane, increased by 1 % every minute until anaesthesia was adequate for tracheal intubation. Anaesthesia was maintained with oxygen, nitrous oxide, and desflurane delivered by mechanical ventilation. During induction of anaesthesia, the incidence of moderate to severe coughing was 20%, breath-holding 14%, and laryngospasm 31 %. Blood pressure fell significantly ( P < 0.05) from baseline after induction of anaesthesia and remained at this level during anaesthesia. Heart rate was stable in children less than six years, but increased significantly in older children. There were no significant airway problems during recovery from anaesthesia. Recovery time was rapid: the time to awakening was 10.2 min and to discharge from the recovery room, 29.2 min. Although desflurane is not an ideal anaesthetic agent for inhalational induction in children, it maintains stable anaesthesia and provides rapid smooth recovery.

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Section: Discussionmentioning

confidence: 52%

Desflurane in paediatric anaesthesia

Mannion

Casey

Doherty

1994

Pediatric Anesthesia

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“…During general anaesthesia 54% of neonates sustained a fall in saturation to 85% or less for at least 30 seconds in a group of 13 neonates reported by Schulz and colleagues 32. Taylor and Lerman33 found a decrease in saturation to less than 90% in 18% of infants aged under one year. Millar and Bisonnette34 did not find any decrease in oxygen saturations in 13 term infants where they practised an awake intubation, but their exclusion criteria included the presence of known intracranial, cardiovascular, or laryngeal pathology.…”

Section: Discussionmentioning

confidence: 95%

Use of methohexital for elective intubation in neonates

Naulaers

Deloof

Vanhole

et al. 1997

Archives of Disease in Childhood - Fetal and Neonatal Edition

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The eVectiveness and safety of a short acting barbiturate, methohexital, was assessed for its use at the time of elective intubation in 18 newborn infants with severe respiratory or cardiac conditions. Evaluation included the speed of action and the degree of relaxation, sedation, and sleep in the first five minutes after administration. All newborn infants were intubated in a fully relaxed and somnolent state. In most infants recovery was completed within five minutes.A slight to moderate oxygen saturation drop was observed during the period of intubation, especially in patients with cyanotic heart disease. The side eVects of the drug were twitching and a slight drop in blood pressure.In conclusion, methohexital seems to be a useful drug for short term anaesthesia in neonates, during which, short procedures like elective intubation can be safely performed. (Arch Dis Child 1997;77:F61-F64)

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“…Favourable physicochemical properties (Lerman et al 1984;Lerman et al 1986) (Table 1) might lead us to anticipate that these anaesthetics would facilitate a more rapid induction of anaesthesia than would halothane. However, the irritant effects of isoflurane, enflurane and desflurane on the upper airway and their depressant effects on the respiratory system more than offset the favourable physicochemical properties (Fisher et al 1985;Pandit, Steude & Leach 1985;McAteer et al 1986;Phillips, Brimacornbe & Simpson 1988;Taylor & Lerman 1992;Zwass et al 1992). The irritant effects of isoflurane and desflurane on the upper airway are manifested in greater incidences of breathholding, coughing, salivation, excitement, laryngospasm and arterial oxygen desaturation when compared with halothane.…”

Section: Xespirato Y Systemmentioning

confidence: 93%

Pharmacology of inhalational anaesthetics in infants and children*

Lerman

1992

Pediatric Anesthesia

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Induction, maintenance and recovery characteristics of desflurane in infants and children

Cited by 103 publications

References 30 publications

Desflurane in paediatric anaesthesia

Desflurane in paediatric anaesthesia

Use of methohexital for elective intubation in neonates

Pharmacology of inhalational anaesthetics in infants and children*

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