Optimum End Tidal Sevoflurane Concentration Required for Intravenous Cannulation in Children

Background Inhalation mask induction is a cornerstone of pediatric anesthesia. Because of their natural aversion to needles, healthy children are usually anesthetized by mask prior to intravenous insertion. The early insertion of an intravenous access provides a means for administering fluids and drugs if an untoward event occurs during inhalational induction. Sevoflurane is the inhalation agent most commonly used for mask inductions in pediatric anesthesia, having largely replaced halothane for this purpose. Objectives The aim of the study was to evaluate the optimum end tidal concentration of Sevoflurane at which an intravenous cannulation can be successfully attempted without movement in pediatric patients. Patients and Methods In this clinical trial, pediatric subjects of either sex aged 2-5 years, weighing 10-20 kg were included. Results Showed that an end tidal sevoflurane of 1.46% has 50% probability for successful intravenous cannulation without movement in children. Conclusion We conclude that an end tidal sevoflurane of 1.46% has 50% probability for successful intravenous cannulation in un- premedicated children aged between 2 and 5 years.

Pediatrics: Congenital Diaphragmatic Hernia

In this chapter the essential aspects of anesthesia for congenital diaphragmatic hernia (CDH) are discussed. Subtopics include respiratory management of CDH patients, airway management, and postoperative considerations of CDH patients. The chapter is divided into preoperative, intraoperative, and postoperative sections with important subtopics related to the main topic in each section. Preoperative topics addressed are assessment of respiratory and circulatory findings, including pulmonary hypertension. Discussion of intraoperative management includes monitoring, induction using inhalational induction, intubation, and maintenance of the patient, airway management, goals for ventilation, treating possible pneumothorax, and fluids used, such as glucose. Postoperative concerns addressed are decompensation and patient outcome.

Airway assessment and management

This chapter discusses the assessment and management of the airway. It begins with methods of assessing the airway and describes the approach to the unanticipated difficult airway. Topics covered include failed intubation, techniques for managing the anticipated difficult intubation, the cannot-intubate-cannot-ventilate scenario, the management of the obstructed airway, rapid sequence induction, inhalational induction, and awake fibreoptic intubation. It concludes with a discussion of extubating the patient after a difficult intubation.