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Inhalational Induction (inhalational + induction)
Selected AbstractsInhalational induction of anaesthesia in adults: time for a breath of fresh air?ANAESTHESIA, Issue 11 2007S. H. McClelland No abstract is available for this article. [source] Pre-oxygenation enhances induction with sevoflurane as assessed using bispectral index monitoringACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 4 2006A. Fassoulaki Background:, Several methods may enhance the inhalational induction of anesthesia. In this randomized double-blind study, we evaluated the speed of induction of anesthesia with sevoflurane with or without pre-oxygenation. Methods:, Fifty-four patients scheduled for hysteroscopy received for 10 min air or 100% oxygen via a facemask followed by , 7% sevoflurane in 100% oxygen. During the first 300 s of sevoflurane administration, bispectral index (BIS) values were recorded every 30 s in all patients. In 14 patients, seven in each group, BIS, endtidal CO2, tidal volume, respiratory rate, SpO2, and heart rate were recorded every minute during the pre-induction period and every 30 s during the first 5 min of sevoflurane administration. Results:, The BIS, endtidal CO2, tidal volume and respiratory rate did not differ between the oxygen or air breathing groups (P = 0.696, P = 0.999, P = 0.388, and P = 0.875, respectively), though the oxygen group exhibited lower tidal volumes by 16,20%. The SpO2 and heart rates were higher in the oxygen breathing group (P < 0.001 and P = 0.042, respectively). During sevoflurane administration, BIS values were lower in the oxygen group vs. the group breathing air, in particular at 90, 120, 150, 180 and 210 s (P = 0.001, P = 0.001, P = 0.001, P = 0.001 and P = 0.030, respectively). The endtidal CO2 and the tidal volumes between the groups did not differ. The two groups differed in the SpO2 and the heart rates during induction (P = 0.004 and 0.003, respectively). Conclusions:, Before sevoflurane administration, breathing 100% oxygen for 10 min enhances induction of anesthesia with sevoflurane. [source] Recovery characteristics of sevoflurane or halothane for day-case anaesthesia in children aged 1,3 yearsACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 1 2000H. Viitanen Background: Our objective was to compare the recovery characteristics of sevoflurane and halothane for short day-case anaesthesia in a specifically limited age group of children 1,3 yr. Methods: Eighty unpremedicated children undergoing day-case adenoidectomy were randomly assigned to receive inhalational induction with either sevoflurane 8% or halothane 5% and nitrous oxide in oxygen (70/30) via a face mask. Tracheal intubation was performed without a muscle relaxant. Anaesthesia was continued with the volatile anaesthetic, adjusted to maintain heart rate and blood pressure within ±20% of initial values. Recovery was evaluated using a modified Aldrete score, a Pain/Discomfort scale and by measuring recovery end-points. A postoperative questionnaire was used to determine the well-being of the child at home until 24 h after discharge. Results: Emergence and interaction occurred significantly earlier after sevoflurane than halothane but discharge times were similar. More children in the sevoflurane group achieved full Aldrete scores within the first 30 min after anaesthesia, although this group suffered more discomfort during the first 10 min. The amount of postoperative analgesic administered was higher and the first dose given earlier in the sevoflurane group. Postoperative vomiting was more common with halothane, but side-effects in the two groups were otherwise similar in the recovery room and at home. Conclusions: In children 1,3 yr, sevoflurane provided more rapid early recovery but not discharge after anaesthesia of <30-min duration. Apart from more vomiting with halothane and more discomfort during the first 10 min after awakening with sevoflurane, the quality of recovery was similar with the two anaesthestics. [source] The efficacy of oral clonidine premedication in the prevention of postoperative vomiting in children following strabismus surgeryPEDIATRIC ANESTHESIA, Issue 1 2001Fumi Handa MD We evaluated the efficacy of clonidine given orally preoperatively for preventing postoperative vomiting (POV) in children undergoing propofol-nitrous oxide anaesthesia for strabismus surgery. Sixty children, ASA physical status I, aged 2,12 years, received diazepam, 0.4 mg·kg,1 or clonidine 4 ,g·kg,1 (n=30 each) orally, in a randomized double-blind manner. These drugs were given 105 min before an inhalational induction of anaesthesia. A complete response, defined as no POV and no need for rescue antiemetic medication, during 0,24 h after anaesthesia was 67% with diazepam and 93% with clonidine, respectively (P=0.024). No clinically adverse event was observed in any of the groups. In summary, pretreatment with oral clonidine enhances the antiemetic efficacy of propofol for the prevention of POV after paediatric strabismus surgery. [source] Pretreatment with oral clonidine attenuates cardiovascular responses to tracheal extubation in childrenPEDIATRIC ANESTHESIA, Issue 1 2000Yoshitaka Fujii MD Summary This study was designed to evaluate the effects of diazepam and clonidine orally given preoperatively on cardiovascular responses to tracheal extubation in children. Fifty children, ASA physical status I, aged 4,10 years, undergoing minor elective surgery (inguinal hernia, phimosis) received orally, in a randomized, double-blind manner, diazepam 0.4 mg·kg,1 or clonidine 4 ,g·kg,1 (n=25 of each). These drugs were administered 105 min before an inhalational induction of anaesthesia. The same standard general anaesthetic technique was employed throughout. The maximum changes in heart rate (HR), systolic blood pressure (SBP) and diastolic blood pressure (DBP) were less in patients who had received clonidine than in those who had received diazepam (HR, 12 vs 24; SBP, 14 vs 26; DBP, 9 vs 16; mean, P < 0.05). In conclusion, compared to diazepam given orally, pretreatment with oral clonidine attenuates haemodynamic changes associated with tracheal extubation in children. [source] A comparison between the GlideScope® Video Laryngoscope and direct laryngoscope in paediatric patients with difficult airways , a pilot studyANAESTHESIA, Issue 4 2010C. Karsli Summary The GlideScope® Video Laryngoscope may improve the view seen at laryngoscopy in adults who have a difficult airway. Manikin studies and case reports suggest it may also be useful in children, although prospective studies are limited in number. We hypothesised that the paediatric GlideScope will result in an improved view seen at laryngoscopy in children with a known difficult airway, compared to direct laryngoscopy. Eighteen children with a history of difficult or failed intubation were prospectively recruited. After inhalational induction, each patient had laryngoscopy performed using a standard blade followed by GlideScope videolaryngoscopy. The GlideScope yielded a significantly improved laryngoscopic view, both with (p = 0.003) and without (p = 0.004) laryngeal pressure. The mean (SD) time taken to achieve the optimal view was 20 (8)s using conventional laryngoscopy and 26 (22)s using the GlideScope® (p = 0.5). The GlideScope® significantly improves the laryngoscopic view obtained in children with a difficult airway. [source] The effect of a heat and moisture exchanger on gas flow in a Mapleson F breathing system during inhalational inductionANAESTHESIA, Issue 6 2000J. M. G. Da Fonseca Heat and moisture exchangers (HMEs) humidify, warm and filter inspired gas, protecting patients and apparatus during anaesthesia. Their incorporation into paediatric anaesthetic breathing systems is recommended. We experienced delays in inhalational induction whilst using a Mapleson F breathing system with an HME. We have demonstrated that the HME significantly alters gas flow within the breathing system. Approximately half of the fresh gas flow is delivered to the patient, the remainder being wasted into the expiratory limb of the breathing system. We suggest that the HME should be removed from the Mapleson F breathing system until inhalational induction is complete, or that the reservoir bag is completely occluded until an effective seal is obtained with the mask. [source] | ||||||||||