Single‐breath vital capacity rapid inhalation induction with sevoflurane: feasibility in children

Abstract

Rapid anesthesia induction using a single-breath technique with 7% sevoflurane is effective and well tolerated in children, particularly in those above 9 years of age, and in fact, success rate was markedly lower in the young age groups.

Sevoflurane induction in cyanotic and acyanotic children with congenital heart disease

“…Since we did not have the correct equipment, we were not able to measure the arterial and endtidal sevoflurane partial pressures, which is a limitation of our study. Instead we used clinical criteria including time to loss of eyelash reflex and centralisation of pupils similar to the studies by Fernandez et al 11 and Lewis et al 12 In our study, the speed of induction using sevoflurane was slower and the duration to loss of eyelash reflex longer in cyanotic children with congenital heart disease when compared with the acyanotic children. This indicates that sevoflurane may induce anaesthesia at different speeds according to the direction of cardiac shunts if they exist.…”

Arterial blood concentration of sevoflurane during single-breath induction and tracheal intubation in gynecologic patients

“…A single-breath vital capacity technique requires a cooperative patient to exhale maximally, accept a tightfitting mask to the face, and inhale a single vital capacity breath with a strange smell of sevoflurane, then holding that breath as long as possible. It is reasonable that the success rate of this technique is highly correlated with age, ranging from 10% in 4 to 5 years old to 75% at 11 years and 95% by 14 years [6]. Philip et al [2] demonstrated 59% of male and female adults for ambulatory surgery lost consciousness in one breath with 8% sevoflurane and 75% N 2 O/O 2 in 39 ± 3 seconds.…”

“…Sevoflurane, with properties of low blood-gas partition coefficient [1], allows rapid and smooth induction for adults [2][3][4] and children [5][6][7]. High concentration sevoflurane with single-breath vital capacity technique has been determined to be a better technique than incremental sevoflurane and halothane in children [7].…”

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

“…The sample size calculation was based on the results of Fernandez et al . [8]. The primary endpoint was time to loss of the eyelash reflex.…”

“…We have previously demonstrated that the vital capacity technique is effective and well tolerated in children. The success rate varies with age and ranges between 10% in 4‐ and 5‐year‐olds to 75% at 11 years and 95% by 14 years [8]. The purpose of the present study was, firstly, to determine whether the vital capacity technique achieved more rapid induction of anaesthesia in children compared to the conventional tidal volume technique and, secondly, to compare the incidence of adverse events and satisfaction scores of the children using these techniques.…”