Single‐breath inhalation induction of sevoflurane anaesthesia with and without nitrous oxide: a feasibility study in adults and comparison with an intravenous bolus of propofol

Anaesthesia ◽  
1997 ◽  
Vol 52 (5) ◽  
pp. 410-415 ◽  
Author(s):  
J. E. Hall ◽  
J. I. M. Stewart ◽  
M. Harmer
1998 ◽  
Vol 89 (2) ◽  
pp. 379-384 ◽  
Author(s):  
Ross C. Agnor ◽  
Nancy Sikich ◽  
Jerrold Lerman

Background The authors compared the speed of induction of anesthesia with sevoflurane with and without nitrous oxide with the speed of halothane and nitrous oxide using a single-breath vital capacity induction. Methods With informed parental consent, 51 healthy unpremedicated children aged 5-12 yr were randomized to inhale a single breath of one of three gas mixtures: 8% sevoflurane in 66% nitrous oxide, 8% sevoflurane in oxygen, or 5% halothane in 66% nitrous oxide. A blinded observer recorded the times to loss of the eyelash reflex, return of conjugate gaze, the presence of airway reflex responses, involuntary movement, and hemodynamic responses. Results Forty-two children completed the study. The times (mean +/- SD) to loss of the eyelash reflex with sevoflurane/nitrous oxide, 38+/-8 s, and for sevoflurane-oxygen, 34+/-12 s, were less than that with halothane-nitrous oxide, 58+/-17 s (P < 0.01). Movement occurred less frequently during sevoflurane than during halothane anesthesia (P < 0.05). The times to return of conjugate gaze and the incidence of airway reflex responses were similar among the groups. The incidence of dysrhythmias in the sevoflurane groups was less than that in the halothane group (P < 0.01). Conclusions Induction of anesthesia with a single breath of 8% sevoflurane with or without 66% nitrous oxide is more rapid than with 5% inspired halothane with 66% nitrous oxide in children. The incidence of movement and dysrhythmias during a single-breath induction with sevoflurane are less than they are with halothane.


1994 ◽  
Vol 76 (5) ◽  
pp. 2130-2139 ◽  
Author(s):  
E. M. Williams ◽  
J. B. Aspel ◽  
S. M. Burrough ◽  
W. A. Ryder ◽  
M. C. Sainsbury ◽  
...  

A theoretical model (Hahn et al. J. Appl. Physiol. 75: 1863–1876, 1993) predicts that the amplitudes of the argon and nitrous oxide inspired, end-expired, and mixed expired sinusoids at forcing periods in the range of 2–3 min (frequency 0.3–0.5 min-1) can be used directly to measure airway dead space, lung alveolar volume, and pulmonary blood flow. We tested the ability of this procedure to measure these parameters continuously by feeding monosinusoidal argon and nitrous oxide forcing signals (6 +/- 4% vol/vol) into the inspired airstream of nine anesthetized ventilated dogs. Close agreement was found between single-breath and sinusoid airway dead space measurements (mean difference 15 +/- 6%, 95% confidence limit), N2 washout and sinusoid alveolar volume (mean difference 4 +/- 6%, 95% confidence limit), and thermal dilution and sinusoid pulmonary blood flow (mean difference 12 +/- 11%, 95% confidence limit). The application of 1 kPa positive end-expiratory pressure increased airway dead space by 12% and alveolar volume from 0.8 to 1.1 liters but did not alter pulmonary blood flow, as measured by both the sinusoid and comparator techniques. Our findings show that the noninvasive sinusoid technique can be used to measure cardiorespiratory lung function and allows changes in function to be resolved in 2 min.


2021 ◽  
Vol 161 ◽  
pp. S1488-S1489
Author(s):  
V. Maradia ◽  
S. Bertschi ◽  
M. Krieger ◽  
S. van de Water ◽  
D. Meer ◽  
...  

2004 ◽  
Vol 21 (Supplement 32) ◽  
pp. 29-30
Author(s):  
P. Hans ◽  
P. Y. Dewandre ◽  
B. Beauve ◽  
V. Llabres ◽  
J. F. Brichant ◽  
...  

2012 ◽  
Vol 117 (6) ◽  
pp. 1253-1261 ◽  
Author(s):  
Stephanie Gibert ◽  
Nada Sabourdin ◽  
Nicolas Louvet ◽  
Marie-Laure Moutard ◽  
Veronique Piat ◽  
...  

Background Sevoflurane has become the gold standard for inhalation induction in children. However in children as in adults, epileptiform electroencephalographic signs have been described under high concentrations of sevoflurane. The aim of this study was to determine the minimal alveolar concentration (MAC) of sevoflurane associated with the occurrence of major epileptiform signs (MES) in 50% children under steady-state conditions. The MAC of MES (MAC MES) was determined in 100% oxygen and with the addition of 50% nitrous oxide or after the injection of alfentanil (ALFENTA). Methods Seventy-nine children (3-11 yr), undergoing elective surgery and premedicated with hydroxyzine were included. After induction by inhalation and tracheal intubation, a 10-min period with a stable expired fraction of sevoflurane was obtained. The MES were defined as rhythmic polyspikes or epileptiform discharges. Electroencephalographic recordings were blindly analyzed by two independent experts. The MAC MES were determined by the Dixon method: the concentration of sevoflurane was determined by the result from the previous patient: increase of 0.2% if MES were absent or decrease of 0.2% if MES were present. Three consecutive series were performed: (1) in 100% oxygen (MAC MESO2); (2) in 50% oxygen and 50% nitrous oxide (MAC MESN2O); and (3) in 100% oxygen with a bolus of alfentanil (MAC MESALFENTA). Results The MAC MESO2 was 4.3±0.1% (mean±SD), the MAC MESN2O and the MAC MESALFENTA were higher, respectively: 4.6±0.2% (P=0.01) and 4.6±0.2% (P=0.02). Conclusions In children premedicated with hydroxyzine, the MAC MES of sevoflurane calculated in 100% O2 corresponded to 1.75 surgical MAC. In addition, our results have demonstrated a moderate effect of nitrous oxide and alfentanil in raising the threshold of MES.


2021 ◽  
Vol 18 (3) ◽  
pp. S61
Author(s):  
A. Gopalakrishna ◽  
R. Bole ◽  
N. Parikh ◽  
M. Ahmed ◽  
E. Pagel ◽  
...  

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