Spontaneous breathing with the use of a laryngeal mask airway in children: comparison of sevoflurane and isoflurane

Komatsu, Hisao; Chujo, Kousuke; Morita, Junko; Ogawa, Noriko; Ueki, Masaaki; Yokono, Satoshi; Ogli, Kenji

doi:10.1046/j.1460-9592.1997.d01-53.x

Cited by 14 publications

(7 citation statements)

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“…[33,[42][43][44][45]49] The decreases were smaller than with desflurane, [51] similar to those with isoflurane [45] and generally similar to [49] or significantly lower [44] than with halothane. Changes in blood pressure and the incidence of hypotension (≥30% decrease in systolic blood pressure) were inversely related to age (the study included neonates aged ≤30 days and children aged 0.5 to 12 years).…”

Section: Other Effects (Contd)mentioning

confidence: 71%

“…[33,[41][42][43][44][45][46][47][48] In 2 studies [41,43] these increases were significantly (p < 0.05) greater than those seen with halothane, but in another [44] the difference was not significant. Results of a study conducted in 30 infants (mean age about 6 months) indicate that sevoflurane (1 to 1.5 MAC), unlike halothane, had no significant effect on heart rate versus awake measurements; halothane-induced decreases in this parameter were significant versus sevoflurane values.…”

Section: Other Effects (Contd)mentioning

confidence: 99%

“…[57] A comparison of sevoflurane and isoflurane (up to 1.3 MAC) in 40 children showed the 2 agents to produce a similar extent and pattern of respiratory depression. [45] Lung and respiratory system resistance routinely increase after tracheal intubation and, on rare occasions, can cause clinical bronchospasm. Sevoflurane, halothane or isoflurane reduced respiratory resistance in 66 patients undergoing tracheal intubation, but the effects of sevoflurane were significantly greater than those of the other anaesthetics.…”

Section: Respiratory Effectsmentioning

confidence: 99%

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Sevoflurane in Paediatric Anaesthesia

Goa¹,

Noble²,

Spencer³

1999

Pediatric Drugs

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Sevoflurane is a preferred anaesthetic agent for induction and maintenance of paediatric anaesthesia because of its rapid induction and recovery characteristics, lack of pungency and agreeable odour, and acceptable cardiovascular profile. Although the issue of postoperative excitement requires clarification, sevoflurane anaesthesia can be considered a rational choice for ambulatory and nonambulatory surgery in children.

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Section: Other Effects (Contd)mentioning

confidence: 71%

Section: Other Effects (Contd)mentioning

confidence: 99%

Section: Respiratory Effectsmentioning

confidence: 99%

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Sevoflurane in Paediatric Anaesthesia

Goa¹,

Noble²,

Spencer³

1999

Pediatric Drugs

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“…It has been shown that LMA insertion time is quicker with sevoflurane than halothane (8). and that cardiorespiratory parameters are similar to isoflurane (9). To our knowledge, there have been no studies comparing the clinical efficacy of sevoflurane and propofol in children.…”

Section: Introductionmentioning

confidence: 99%

Sevoflurane versus propofol for induction and maintenance of anaesthesia with the laryngeal mask airway in children

Gil

Brimacombe

Clar

1999

Pediatric Anesthesia

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We compared patient outcomes for propofol vs sevoflurane with the laryngeal mask airway (LMA) using either spontaneous breathing (SB) or pressure controlled ventilation (PCV). One hundred and twenty children undergoing minor surgery below the umbilicus were randomly assigned to receive either (1) propofol 3 mg.kg-1 followed by a maintenance infusion of 5 mg.kg-1.h-1, or (2) induction with sevoflurane 7% followed by maintenance with 1.7%. Following LMA insertion, patients were given atracurium and underwent PCV if surgery was expected to last > or = 30 min. The following assessments were made: time to LMA insertion/removal, airway problems, cardiorespiratory effects and recovery characteristics. The first time insertion success rates were similar, but insertion time was shorter with sevoflurane (115 +/- 67 s vs 252 +/- 107 s, P < 0.0001). One patient coughed during placement, but there were no other problems during any phase of anaesthesia in any group. Heart rate was higher in the sevoflurane group following insertion, during maintenance and emergence (all P < 0.03). There were no differences in blood pressure and oxygen saturation among groups PECO2 in the SB group was unaffected by the agent used. Emergence was more rapid (232 +/- 104 s vs 348 +/- 127 s, P < 0.0001) and postoperative agitation more common (15% vs 0%, P = 0.02) with sevoflurane. There were no differences in the Aldrete scores among groups. Patient outcome was similar for the SB and PCV groups. We concluded that the techniques described here using propofol and sevoflurane are equally suitable for induction and maintenance of anaesthesia with the LMA in children undergoing minor surgery below the umbilicus. Emergence is more rapid, but postoperative agitation more common with sevoflurane.

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“…However, the changes did not show significance after post hoc correction, indicating that changes in RR and MV during muscle traction did not differ between the LR and MR surgeries. In this study, sevoflurane was used for anesthetic maintenance [10,[20][21][22][23]; its effect on respiration has not yet been fully elucidated. We note that the increase in RR (by ~20%) was greater than the magnitude of change in TV (~10%) during muscle traction.…”

Section: Discussionmentioning

confidence: 99%

Oculocardiac and Oculorespiratory Reflex during Strabismus Surgery under General Anesthesia with Laryngeal Mask Airway for Maintaining Spontaneous Respiration: A Retrospective Study

Shin

Kim

Joo

2019

Preprint

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Background: The oculocardiac reflex (OCR) is defined as a 10–20% reduction in heart rate (HR) from the baseline value or dysrhythmia, and the oculorespiratory reflex (ORR) manifests as shallow respiratory movement and bradypnea caused by manipulation of the eye. The aim of this study was to elucidate whether the specific muscle operated on has an effect on OCR and ORR, as well as whether the depth of anesthesia influences the OCR and ORR in patients undergoing strabismus surgery with laryngeal mask airway (LMA) to maintain spontaneous respiration. Methods: The medical records of patients who underwent strabismus surgery on lateral rectus (LR) and medial rectus (MR) muscles from January 2017 to December 2017 were reviewed. For anesthesia induction, propofol was administered and the LMA was inserted. Anesthesia was maintained with sevoflurane and spontaneous respiration. Results: The incidences of OCR during LR and MR operations were not significantly different between pediatric and adult patients (29% vs 27% and 15% vs 16%, respectively, p < 0.05). The incidence of ORR, as indexed by tidal volume (TV), was higher during MR surgery than during LR surgery in pediatric patients (29.3% vs 10.1%, p < 0.05). The change in HR during muscle traction and bispectral index (BIS) showed a negative correlation in pediatric patients, but this was not statistically significant. The change in TV during muscle traction and BIS was significantly correlated, in both pediatric and adult patients (r2 = 0.034 and 0.058, respectively, p < 0.05), while the change in respiratory rate (RR) during muscle traction and BIS did not show a significant correlation in either group. Conclusions: The incidence rate of OCR did not differ between LR and MR surgeries, and the depth of anesthesia did not correlate with HR changes during muscle traction. Young age and MR surgery may be risk factors for ORR. However, MV did not decrease because of the increased RR during muscle traction. Thus, maintenance of spontaneous respiration with an LMA is safe during strabismus surgery under general anesthesia for both pediatric and adult patients.

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Spontaneous breathing with the use of a laryngeal mask airway in children: comparison of sevoflurane and isoflurane

Cited by 14 publications

References 1 publication

Sevoflurane in Paediatric Anaesthesia

Sevoflurane in Paediatric Anaesthesia

Sevoflurane versus propofol for induction and maintenance of anaesthesia with the laryngeal mask airway in children

Oculocardiac and Oculorespiratory Reflex during Strabismus Surgery under General Anesthesia with Laryngeal Mask Airway for Maintaining Spontaneous Respiration: A Retrospective Study

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