L’apnée pendant l’induction de l’anesthésie avec du sévoflurane est reliée au mode d’administration

Pancaro, Carlo; Giovannoni, S.; Toscano, Adelchi; Peduto, V. A.

doi:10.1007/bf03015767

Cited by 20 publications

(9 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Previous study has showed that apnea occurred in 16% of patients experienced anesthesia induction with sevoflurane for laryngeal mask insertion [ 34 ]. Pancaro et al have reported that the incidence of apnea during anesthesia induction of sevoflurane ranged from 20% to 68% [ 35 ]. For one thing, the additional propofol was adopted in ‘movement’ patients, which may have resulted in the increased incidence of apnea.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

The optimum sevoflurane concentration for supraglottic airway device Blockbuster™ insertion with spontaneous breathing in obese patients: a prospective observational study

et al. 2017

View full text Add to dashboard Cite

BackgroundAirway management of the obese patient presenting for surgery is more likely to be a challenging problem. Supraglottic airway device has been adopted as a bridge to connect ventilation and tracheal intubation in obese patients who would be suffered with difficult intubation. The optimum sevoflurane concentration for supraglottic airway device insertion allowing spontaneous breathing in 50% of obese patients (ED50) is not known. The purpose of this study was to determine the ED50 of sevoflurane for supraglottic airway device Blockbuster™ insertion with spontaneous breathing in obese patients requiring general anesthesia.MethodsThirty elective obese patients (body mass index 30-50 kg/m2) undergoing bariatric surgery were recruited in this study. The predetermined target sevoflurane concentration (initiating at 2.5% with 0.5% as a step size) was sustained for >5 min using a modified Dixon’s up-and-down method, and then the supraglottic airway device Blockbuster™ was inserted. The patient’s response to supraglottic airway device insertion was classified as either ‘movement’ or ‘no-movement’. The ED50 of sevoflurane were determined by calculating the midpoint concentration of crossover point from ‘movement’ or ‘no-movement’ response.ResultsThe ED50 of sevoflurane for supraglottic airway device Blockbuster™ insertion in obese patients calculated using up-and-down method were 2.50 ± 0.60%. The ED50 and ED95 (95% confidence interval) obtained by probit regression analysis were 2.35 (1.28–3.42) % and 4.03 (3.16–17.83) % for supraglottic airway device Blockbuster™ insertion, respectively.ConclusionWe conclude that the optimum end-tidal sevoflurane concentration required for the supraglottic airway device Blockbuster™ insertion allowing spontaneous breathing in 50% of obese patients (ED50) is 2.5 ± 0.6%.Trial registrationChinese Clinical Trial Registry, ChiCTR-IPR-16009071, Registered on 24 August 2016.

show abstract

Section: Discussionmentioning

confidence: 99%

“…Apnea during anesthesia induction with sevoflurane is correlated with its mode of administration. The faster and higher concentration of sevoflurane is inhaled the higher is the probability the patient will suffer with apnea [ 35 ].…”

Section: Discussionmentioning

confidence: 99%

The optimum sevoflurane concentration for supraglottic airway device Blockbuster™ insertion with spontaneous breathing in obese patients: a prospective observational study

et al. 2017

View full text Add to dashboard Cite

show abstract

“…In addition, apnea during the period of anesthesia induction with sevoflurane is associated with its mode of administration. The study by Pancaro et al [ 25 ] showed that apnea occurred in 21%, 20%, 68% of patients induced with sevoflurane at incremental concentrations of 1% (from 1% to 8%), decremental-incremental concentrations of 2% (from 8% to 4% to 8%), and a fixed concentration of 8%, respectively. The higher concentration of sevoflurane is administered, the higher is the probability that the participant will suffer with apnea.…”

Section: Discussionmentioning

confidence: 99%

Optimum end-tidal concentration of sevoflurane to facilitate supraglottic airway device insertion with propofol at induction allowing spontaneous respiration in obese patients

Wang

Miao²,

Gao³

et al. 2017

Medicine

View full text Add to dashboard Cite

Obese patients are more likely to encounter with difficult airway management, and supraglottic airway device has been adopted to facilitate tracheal intubation. The optimum anesthetic concentration for obese patients to insert a supraglottic airway device with spontaneous respiration has not been investigated. This study was designed to determine the end-tidal concentration of sevoflurane that would provide acceptable condition for supraglottic airway device insertion with propofol at induction in obese patients without using neuromuscular blockade.Thirty elective obese patients [body mass index (BMI) 30–50 kg/m2] scheduled for bariatric surgery were enrolled in this study. Sevoflurane was inhaled at a concentration of 5% after infusion of 1 mg/kg propofol (within 1 minute) according to lean body weight. The target concentration of sevoflurane was initiated at 2.5% with 0.5% as a step size using a modified Dixon up-and-down method. Five minutes after target concentration achieved, the insertion of supraglottic airway device was attempted.The minimum alveolar concentration of sevoflurane for successful insertion of supraglottic airway device calculated using up-and-down method were 2.25 (0.53) % for obese patients. The values of the effective concentration of sevoflurane for successful supraglottic airway device insertion in 50% (EC50) and 95% (EC95) of the obese patients obtained by probit regression analysis were 2.09% (95% confidence interval 1.48–2.68) and 3.31% (95% confidence interval 2.70–8.12), respectively.We conclude that sevoflurane at a minimum alveolar concentration of 2.25% can provide optimal conditions for insertion of supraglottic airway device with spontaneous respiration in obese patients with 1 mg/kg propofol at induction.

show abstract

“…The faster sevoflurane is administered the higher the chance the patient will become apneic. 24 Respiratory irregularities can also contribute to the prolongation of IIAS. The deepening of inhalation anesthesia is obviously hampered by apnea, and this may have contributed to the longer intervals observed in our placebo group before loss of eyelash reflex and PLMA insertion.…”

Section: Discussionmentioning

confidence: 99%

Low-dose fentanyl-midazolam combination improves sevoflurane induction in adults

Lesage

Drolet

Donati

et al. 2009

Can J Anesth/J Can Anesth

View full text Add to dashboard Cite

Purpose We investigated the effects of a combination of low-dose fentanyl-midazolam premedication on the speed of inhaled induction with sevoflurane and ProSeal TM laryngeal mask airway (PLMA) insertion conditions. Methods Eighty adult patients undergoing elective surgery were randomized in a double-blind fashion to receive either a normal saline placebo (Group PLAC) or a fentanyl 0.6 lg Á kg -1 and midazolam 9 lg Á kg -1 premedication (Group FM) 5 min before tidal volume sevoflurane 8%/O 2 induction. Anxiety levels, times to loss of eyelash reflex (LER) and PLMA insertion, and cardiorespiratory data were recorded. Results Times to LER (Group PLAC: 66 ± 34 sec vs Group FM: 47 ± 18 sec, P = 0.0027, difference = 19 sec: 95% confidence interval [CI] 7-31 sec) and to PLMA insertion (Group PLAC: 186 ± 80 sec vs Group FM: 119 ± 44 sec, P \ 0.0001, difference = 68 sec: 95% CI 39-97 sec) were shorter following FM. After PLMA insertion, end-tidal sevoflurane concentration (EtSevo) was lower and end-tidal CO 2 (EtCO 2 ) was higher following FM. Respiratory rate (RR) was lower with FM, but there was no difference regarding tidal volume. Adverse events, such as movements and apnea, occurred more often in Group PLAC. Systolic blood pressure (SBP) and heart rate (HR) during induction were both lower with FM. Anxiety level after premedication was lower following FM administration. All participants remembered the face mask being applied in Group PLAC vs 69% in Group FM, P \ 0.0001. Conclusion Administration of a low-dose fentanylmidazolam combination prior to sevoflurane induction decreases time to LER and allows for more rapid and less eventful PLMA insertion. Both SBP and HR were lower when premedication was administered. Patients receiving premedication were less anxious and less likely to remember the face mask. However, premedication was associated with a lower RR and increased EtCO 2 values following PLMA insertion, in spite of lower EtSevo concentrations. (ClinicalTrials.gov ID NCT00723164). RésuméObjectif Nous avons examine´les effets d'une combinaison de fentanyl -midazolam a`faible dose en pre´me´dication sur la vitesse d'une induction par inhalation de se´voflurane et sur les conditions d'insertion du masque larynge´Pro-Seal TM (PLMA). Méthode Quatre-vingts patients adultes subissant une chirurgie non urgente ont e´te´randomise´s en double aveugle a`recevoir soit un placebo de solution sale´e (groupe PLAC) ou une pre´me´dication compose´e de fentanyl 0,6 lgÁkg -1 et midazolam 9 lgÁkg -1 (groupe FM) cinq minutes avant l'induction avec du se´voflurane 8 %/O 2 av olume courant. Les niveaux d'anxie´te´, le temps jusqu'a`la perte du re´flexe ciliaire (PRC) et l'insertion du PLMA ainsi que les donne´es cardiorespiratoires ont e´te´enregistre´es. Résultats Les temps jusqu'a`PRC (groupe PLAC : 66 ± 34 secondes vs groupe FM : 47 ± 18 secondes, P = 0,0027, diffe´rence = 19 secondes : intervalle de confiance [IC] 95 % 7-31 secondes) et jusqu'a`insertion du PLMA (groupe PLAC : 186 ± 80 secondes vs groupe FM : 119 ± 44 s...

show abstract

L’apnée pendant l’induction de l’anesthésie avec du sévoflurane est reliée au mode d’administration

Cited by 20 publications

References 15 publications

The optimum sevoflurane concentration for supraglottic airway device Blockbuster™ insertion with spontaneous breathing in obese patients: a prospective observational study

The optimum sevoflurane concentration for supraglottic airway device Blockbuster™ insertion with spontaneous breathing in obese patients: a prospective observational study

Optimum end-tidal concentration of sevoflurane to facilitate supraglottic airway device insertion with propofol at induction allowing spontaneous respiration in obese patients

Low-dose fentanyl-midazolam combination improves sevoflurane induction in adults

Contact Info

Product

Resources

About