Sevoflurane versus halothane for induction of anesthesia in pediatric and adult patients

Abstract

Induction of anesthesia using an inhalation agent remains a fundamental technique due to its rapid induction and emergence. Sevoflurane is preferred over halothane for its faster induction of anesthesia and lesser complications. Studies on sevoflurane in pediatrics have established it as safe and effective. However, its effectiveness in adults is very limited. Hence, this study was conducted to compare the induction and intubating conditions, hemodynamic profiles, and emergence from anesthesia with sevoflurane and halothane in adults and pediatric patients. This randomized clinical study was carried out for a period of 2 years (November 2006–September 2008) in the Anesthesiology Department of a Krishna Institute of Medical Sciences (Deemed to be) University. Eighty patients of American Society of Anesthesiologists Class I and II were randomly assigned to halothane group and sevoflurane group with 40 patients in each group. Patients were induced and intubated with increasing concentrations of halothane from 0.5% to 5% and sevoflurane 1% to 7% in 50% nitrous oxide and 50% oxygen mixture. Recordings of vitals including induction and intubation time, recovery characteristics, and recovery and discharge time was also recorded. There was a statistically significant difference between sevoflurane and halothane in the induction and intubation time indicating that sevoflurane had faster induction and shorter intubation time compared to that of halothane. Patients in halothane group had more incidence of coughing, intolerance, salivation, breathe holding, rigidity, and movement as compared to sevoflurane group. The mean time to consciousness, response to verbal commands, orientation, and recovery room discharge time was significantly shorter in sevoflurane group as compared to halothane group. Sevoflurane can be a suitable alternative to halothane for induction of anesthesia in patients with a shorter induction and intubation time with better hemodynamic stability. This study was approved by the Institutional Ethics Committee (KIMSDU/IEC-307/028/14/11/2006).

Effects of Sevoflurane Laryngeal Mask Inhalation Combined with Intravenous Anesthesia on Perioperative Stress and Myocardial Injury in Elderly Patients with Acute Cholecystitis and Coronary Heart Disease

“…Due to rapid induction and small tissue uptake, the patient recovered quickly after surgery. Studies have confirmed that patients under sevoflurane anesthesia generally recover less than 10 minutes after drug discontinuation, and patients have no symptoms of falling asleep again after waking up, and there are obvious complications such as nausea and vomiting, dizziness, headache, cough, throat and bronchospasm, edema, and other complications [ 10 , 11 ].…”

Is it a normal phenomenon for pediatric patients to have brain leptomeningeal contrast enhancement on 3-tesla magnetic resonance imaging?

“…McKinney et al [ 3 ] discovered that prominent leptomeningeal contrast enhancement (pLMCE) can occur in pediatric patients who are under anaesthesia with propofol. However, in clinical practice, the administration of sevoflurane has become a common anaesthetic practice for pediatric patients undergoing magnetic resonance imaging (MRI) due to advantages such as rapid induction and recovery[ 4 ]. Nevertheless, whether sevoflurane can also induce pLMCE remains a scientific question that needs resolution.…”

Olfactory bulbectomy leads to prolonged induction phase of sevoflurane anesthesia in rats

“…Animals were randomly divided into three groups by blinded experimenters. 0.2 mL/kg of the anesthetic combination (ketamine HCl, 150 mg/1.5 mL; xylazine HCL, 30 mg/1.5 mL; and distilled water, 1 mL) was subcutaneously injected before surgery to reduce animals' pain as reported in the study by Kanat et al 14 The animals were fixed in a stereotactic frame (Stoelting Co., Wood Dale, IL, USA). Volatile anesthetic sevoflurane was administered using a modified anesthesia unit.…”

“…Mean induction time was assessed based on the time interval between the placement of the face mask and the loss of eyelash reflex. 14 As the mean induction time was found to be 135 seconds, the higher value of 165 seconds was accepted as a late induction time. The instant when the first signs of inactivity appeared was recorded to estimate the depth of anesthesia.…”