Optimal dose of sufentanil in children for intubation after sevoflurane induction without neuromuscular block

Soulard, A.; Babre, F.; Bordes, M.; Meymat, Y.; Sztark, F.; Cros, A. M.

doi:10.1093/bja/aep044

Cited by 23 publications

(17 citation statements)

References 30 publications

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“…Min et al [2] reported that the bolus dose of remifentanil required for successful tracheal intubation was 0.56 ± 0.15 lg/kg in 50% of children during inhalation induction using 5% sevoflurane in the absence of neuromuscular blocking drugs. In addition, the effective dose of sufentanil required for excellent intubation conditions was 0.11 ± 0.07 lg/kg at end-tidal sevoflurane of 3.5% for 50% of children [4]. Considering the equipotent dose of each opioid agent, their results were consistent with the results of this study.…”

Section: Discussionsupporting

confidence: 87%

“…When difficult intubation is anticipated or airway obstruction occurs, this technique is favored over intravenous induction. Several studies have reported on tracheal intubation conditions during induction of sevoflurane inhalation with variable opioid agents without neuromuscular blockade in children [2,4]. Min et al [2] reported that the bolus dose of remifentanil required for successful tracheal intubation was 0.56 ± 0.15 lg/kg in 50% of children during inhalation induction using 5% sevoflurane in the absence of neuromuscular blocking drugs.…”

Section: Discussionmentioning

confidence: 99%

“…Addition of an opioid during sevoflurane inhalation induction has been shown to provide good to excellent intubating conditions and allow rapid tracheal intubation without neuromuscular blockade [2,3]. In addition, opioids decrease the target cerebral concentration of sevoflurane needed to perform tracheal intubation in children [4]. In a recent previous study, the effective bolus dose of alfentanil for successful tracheal intubation was 11.5 lg/kg in 50% of children during inhalation induction using sevoflurane 5% and oxygen 100% without a neuromuscular blocking agent [5].…”

Section: Introductionmentioning

confidence: 99%

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The effect of ketamine on tracheal intubating conditions without neuromuscular blockade during sevoflurane induction in children

et al. 2011

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Purpose The purpose of this study was to investigate the effect of ketamine on intubating conditions for tracheal intubation during anesthesia induction with sevoflurane and alfentanil in pediatric patients. Methods After obtaining parental consents, 50 children, aged 3-10 years, were randomly allocated into two groups to receive either i.v. ketamine 0.5 mg/kg (ketamine group, n = 25) or i.v. saline 5 ml (control saline group, n = 25). One minute after injection of the study drug (ketamine or saline), anesthesia was induced with 5% sevoflurane, followed by injection of alfentanil 10 lg/kg 1 min later. The trachea was intubated 4 min after inhalational induction of anesthesia. Acceptable intubation was defined as excellent or good intubating conditions. Mean arterial pressure (MAP) and heart rate (HR) were recorded during the induction period. Results The percentage of patients with acceptable intubating conditions was higher in the ketamine group (87%) than in the control group (52%) (P = 0.0129). MAP before intubation was significantly lower in the control group than in the ketamine group (P = 0.001).Conclusion This study demonstrated that administration of ketamine 0.5 mg/kg could improve intubating conditions for tracheal intubation without neuromuscular blockade and preserve hemodynamic stability during sevoflurane inhalation induction with alfentanil in children.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The effect of ketamine on tracheal intubating conditions without neuromuscular blockade during sevoflurane induction in children

et al. 2011

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“…Studies performed on a neonatal population are lacking, but some data on children 2-9 years of age, 0.3 μg/kg sufentanil combined with 2.5 mg/ kg of propofol, and vecuronium, effectively blunted the cardiovascular responses to tracheal intubation [ 190 ]. The ED 50 for sufentanil for excellent intubating conditions decreased as the expired fraction of sevofl urane increased in children [ 191 ]. For example, at 3 % of sevofl urane, the ED 50 was 0.32 μg/kg sufentanil.…”

Section: Inhalational Inductionmentioning

confidence: 96%

Selection of Anesthesia Techniques for the Neonate

Sabourdin

Louvet

Constant

2014

Neonatal Anesthesia

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“…Several strategies have been developed to speed the induction time and improve the quality of tracheal intubation during sevoflurane induction in children, such as extended exposure to sevoflurane,[4] high inspired fraction of sevoflurane,[5] clonidine premedication,[12] and addition of nitrous oxide,[13] opioids,[14151617] or propofol. [18]…”

Section: Introductionmentioning

confidence: 99%

Using fentanyl and propofol for tracheal intubation during sevoflurane induction without muscle relaxants in children: A randomized prospective study

et al. 2017

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Context:Tracheal intubation is frequently facilitated with sevoflurane induction without the use of muscle relaxants in children.Aim:The aim of this study was to compare the effects of two different doses of propofol preceded by a fixed dose of fentanyl during sevoflurane induction on quality of tracheal intubation in children.Settings and Design:This was a prospective randomized study.Subjects and Methods:Ninety American Society of Anesthesiologists I-II children aged 2–6 years were randomly assigned to one of two equal groups to receive 2 μg/kg of fentanyl with 2 mg/kg of propofol (Group I) or 2 μg/kg of fentanyl with 3 mg/kg of propofol (Group II) during sevoflurane induction. The intubating conditions and hemodynamic responses were evaluated. The time from sevoflurane induction to loss of consciousness, to intravenous line insertion, and to intubation was measured. The occurrence of any adverse effect was recorded.Statistical Analysis Used:Results were analyzed using Student's t-test, paired t-test, and Chi-square test. P < 0.05 was considered statistically significant.Results:The incidence of excellent intubating conditions was achieved more significantly in Group II (41/45 patients, 91%) than that in Group I (31/45 patients, 69%) (P = 0.008) (95% confidence interval [CI] =0.39–0.8). Whereas, there were no significant differences between the two groups in terms of the overall acceptable intubating conditions in Group I (40/45 patients, 89%) and Group II (43/45 patients, 96%) (P = 0.81) (95% CI = 0.71–1.31). No patient developed any adverse effect.Conclusion:The administration of 3 mg/kg propofol preceded by 2 μg/kg fentanyl provided a higher proportion of excellent intubating conditions compared with 2 mg/kg propofol preceded by 2 μg/kg fentanyl during sevoflurane induction in children without muscle relaxants.

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Optimal dose of sufentanil in children for intubation after sevoflurane induction without neuromuscular block

Abstract: Excellent intubation conditions could be obtained in children after inhalation induction with low sevoflurane concentrations and adjuvant sufentanil.

Cited by 23 publications

References 30 publications

The effect of ketamine on tracheal intubating conditions without neuromuscular blockade during sevoflurane induction in children

The effect of ketamine on tracheal intubating conditions without neuromuscular blockade during sevoflurane induction in children

Selection of Anesthesia Techniques for the Neonate

Using fentanyl and propofol for tracheal intubation during sevoflurane induction without muscle relaxants in children: A randomized prospective study

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