scholarly journals Clinical Application of Rapid Inhalation Induction of Anesthesia Using Isoflurane and Sevoflurane with Nitrous Oxide in Dogs.

1995 ◽  
Vol 57 (6) ◽  
pp. 1121-1124 ◽  
Author(s):  
Tatsushi MUTOH ◽  
Ryohei NISHIMURA ◽  
Hwi-yool KIM ◽  
Satoru MATSUNAGA ◽  
Tsuyoshi KADOSAWA ◽  
...  
Keyword(s):  
Nitrous Oxide ◽  
Clinical Application ◽  
Inhalation Induction

scholarly journals Epileptogenic Effect of Sevoflurane

2012 ◽  
Vol 117 (6) ◽  
pp. 1253-1261 ◽  
Author(s):  
Stephanie Gibert ◽  
Nada Sabourdin ◽  
Nicolas Louvet ◽  
Marie-Laure Moutard ◽  
Veronique Piat ◽  
...  
Keyword(s):  
Nitrous Oxide ◽  
Gold Standard ◽  
Elective Surgery ◽  
Consecutive Series ◽  
Minimal Alveolar Concentration ◽  
Inhalation Induction ◽  
Epileptiform Discharges ◽  
Dixon Method ◽  
Moderate Effect ◽  
High Concentrations

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.

Effects of Anticholinergics on Postoperative Vomiting, Recovery, and Hospital Stay in Children Undergoing Tonsillectomy with or without Adenoidectomy 

1999 ◽  
Vol 90 (3) ◽  
pp. 697-700 ◽  
Author(s):  
Ashwani K. Chhibber ◽  
Stewart J. Lustik ◽  
Rajbala Thakur ◽  
David R. Francisco ◽  
Kenneth B. Fickling
Keyword(s):  
Nitrous Oxide ◽  
Hospital Stay ◽  
Neuromuscular Blockade ◽  
Oxygen Mixture ◽  
Postanesthesia Care Unit ◽  
Postoperative Vomiting ◽  
Inhalation Induction ◽  
Number Of Patients ◽  
Significant Difference ◽  
Nitrous Oxide Oxygen

Background Nausea and vomiting are the most frequent problems after minor ambulatory surgical procedures. The agents used to induce and maintain anesthesia may modify the incidence of emesis. When neuromuscular blockade is antagonized with anticholinesterases, atropine or glycopyrrolate is used commonly to prevent bradycardia and excessive oral secretions. This study was designed to evaluate the effect of atropine and glycopyrrolate on postoperative vomiting in children. Methods Ninety-three patients undergoing tonsillectomy with or without adenoidectomy were studied. After inhalation induction of anesthesia with nitrous oxide, oxygen, and halothane, anesthesia was maintained with a nitrous oxide-oxygen mixture, halothane, morphine, and atracurium. Patients were randomized to receive, in a double-blinded manner, either 15 microg/kg atropine or 10 microg/kg glycopyrrolate with 60 microg/kg neostigmine to reverse neuromuscular blockade. Patient recovery, the incidence of postoperative emesis, antiemetic therapy, and the duration of postoperative hospital stay were assessed. Results There were no significant differences in age, gender, weight, or discharge time from the postanesthesia care unit or the hospital between the groups. Twenty-four hours after operation, the incidence of vomiting in the atropine group (56%) was significantly less than in the glycopyrrolate group (81%; P<0.05). There was no significant difference between the atropine and glycopyrrolate groups in the number of patients who required antiemetics or additional analgesics. Conclusions In children undergoing tonsillectomy with or without adenoidectomy, reversal of neuromuscular blockade with atropine and neostigmine is associated with a lesser incidence of postoperative emesis compared with glycopyrrolate and neostigmine.

scholarly journals Rapid inhalation induction with halothane-nitrous oxide for myasthenic patients

1994 ◽  
Vol 41 (2) ◽  
pp. 102-106 ◽  
Author(s):  
Pedro P. Ruiz-Neto ◽  
Helio Halpern ◽  
Eugesse Cremonesi
Keyword(s):  
Nitrous Oxide ◽  
Inhalation Induction

Rapid Inhalation Induction with Halothane-Nitrous Oxide for Myasthenic Patients

1995 ◽  
Vol 39 (1) ◽  
pp. 22
Author(s):  
P. P. RUIZ-NETO ◽  
H. HALPERN ◽  
E. CREMONESI
Keyword(s):  
Nitrous Oxide ◽  
Inhalation Induction

Single-breath Vital Capacity Rapid Inhalation Induction in Children 

1998 ◽  
Vol 89 (2) ◽  
pp. 379-384 ◽  
Author(s):  
Ross C. Agnor ◽  
Nancy Sikich ◽  
Jerrold Lerman
Keyword(s):  
Nitrous Oxide ◽  
Vital Capacity ◽  
Involuntary Movement ◽  
Halothane Anesthesia ◽  
Inhalation Induction ◽  
Reflex Responses ◽  
Single Breath ◽  
Airway Reflex ◽  
The Times ◽  
Informed Parental Consent

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.

Echocardiography. Clinical application in mitral stenosis

JAMA ◽  
1966 ◽  
Vol 195 (3) ◽  
pp. 161-166 ◽  
Author(s):  
B. L. Segal
Keyword(s):  
Clinical Application ◽  
Mitral Stenosis
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