Inhalation induction using sevoflurane in children: the single‐breath vital capacity technique compared to the tidal volume technique*

Abstract

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.

Premedication and induction of anaesthesia in paediatric patients

“…This technique is suitable for children 5 years and older, with faster induction times compared with the conventional tidal volume technique. [30] The effectiveness and success of the vital capacity technique increase with age. For children unable to hold a vital capacity breath, a double-breath vital capacity induction is a suitable alternative.…”

Comparison of the Single Breath Vital Capacity Technique with the Tidal Volume Technique

“…Dilution of sevofl urane is reduced and the highest possible alveolar concentration of sevofl urane is maintained. A high-inspired sevofl urane concentration ensures that the alveolar partial pressure of sevofl urane approaches the inspired partial pressure and off sets uptake of sevofl urane by arterial blood in the lungs(concentration eff ect) 14 .…”

Efficacy of different concentrations of sevoflurane administered through a face mask for magnetic resonance imaging in children

“…We have encountered a limited number of studies that describe sevoflurane anesthesia for MRI procedures performed under spontaneous respiration (1,2). It is thought that deep anesthesia attained at high sevoflurane concentrations may cause problems such as hypoxia, bradycardia, and prolonged recovery time, not to mention increases in procedure costs (13–16).…”