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Tidal breathing technique for induction of anaesthesia with high concentration of sevoflurane, isoflurane or halothane in infants undergoing cardiac surgery

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Abstract

Aims

nduction characteristics of sevoflurane were compared with isoflurane and halothane in 45 acyanotic infants undergoing surgery for congenital heart disease.

Methods

Infants were randomized into three groups of 15 each. None of them received premedication. In group I induction was done with 8% sevoflurane in 100% oxygen, in group II with 5% isoflurane in 100% oxygen and in group III with 4% halothane in 100% oxygen.

Induction time, intubation time, haemodynamic variables and side effects like coughing, laryngospasm, breatholding and excessive crying were noted.

Results

The mean induction time taken as loss of eyelash reflex was significantly lower in sevoflurane group (52.80±8.5 seconds) as compared to isoflurane (196.80±49.13 seconds) and halothane groups (168.72±9.1 seconds) (p value <0.001). The mean intubation time in sevoflurane group was 2.97±0.48 minutes followed by halothane group (5.10±2.9 minutes) and isoflurane group (6.70±1.77 minutes) (p value < 0.001).

The incidence of coughing and laryngospasm was observed in 6% (1 in 15), each in sevoflurane and halothane groups and 20% (3 in 15) cases in isoflurane group. Haemodynamics were comparable in both sevoflurane and isoflurane groups. However in halothane group significant decrease in mean arterial pressure was observed.

Conclusion

Sevoflurane anaesthesia is a better alternative for induction in infants undergoing cardiac surgery as compared to isoflurane and halothane. (Ind J Thorac Cardiovasc Surg, 2001; 17:233-237)

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References

  1. Agnor RC, Sikich N, Lerman J. Single breath vital capacity rapid inhalation induction in children (8% sevoflurane versus 5% halothane). Anesthesiology 1998; 89:379–384.

    Article  PubMed  CAS  Google Scholar 

  2. Murray DJ, Vandewalker G, Matherne P, Mahoney L, Ponto L. Cardiovascular effects of isoflurane and halothane in infants using pulsed doppler echocardiography. Anesthesiology Sept. 1986; 65: No. 3A:A441.

    Article  Google Scholar 

  3. Greeley WJ, Bushman G, Davis OP, Reves J. Comparative effects of ketamine and halothane on arterial oxygen saturation in children with cyanotic heart disease. Anesthesiology Sept. 1986; 65 No. 3A:A440.

    Article  Google Scholar 

  4. Cook DR, Davis PJ, Lerman J. Pharmacology of paediatric anaesthesia. In Motoyama EK, Davis PJ, eds. Smith’s anesthesia for infants and children. Missouri USA, Mosby Inc. 1996; 180.

    Google Scholar 

  5. Ti LK, Pua HL, Lee TL. Single breath vital capacity inhalational anaesthetic induction in adults. Isoflurane versus sevoflurane. Canadian Journal of Anesthesia 1998; 45(10):949–53.

    PubMed  CAS  Google Scholar 

  6. Dashfield AK, Birt DJ, Thurlow J, Kestin IG and Langton JA. Recovery characteristics using single breath 8% sevoflurane or propofol for induction of anaesthesia in day-case arthroscopy patients. Anaesthesia 1998; 53:1062–1066.

    Article  PubMed  CAS  Google Scholar 

  7. Frink EJ, Malan TP, Mathew A, Dominguez LM, Dinardo JA. Clinical comparison of sevoflurane and isoflurane in healthy patients. Anesth Analg 1992; 74:241–245.

    PubMed  Google Scholar 

  8. Enomata S, Watanobe S, Taguchi M, Okada M. End tidal sevoflurane concentration for tracheal intubation and minimum alveolar concentration in pediatric patients. Anesthesiology 1994; 80 (1):93–6.

    Article  Google Scholar 

  9. Brown K, Cindy A, Stockes J, Jackson E, Mackersie A, Hatch D. A comparison of the respiratory effects of sevoflurane and halothane in infants and young children. Anesthesiology 1998; 89:86–92.

    Article  PubMed  CAS  Google Scholar 

  10. Sloan MH, Conard PF, Karsunky PK, Gross JB. Sevoflurane versus isoflurane: Induction and recovery characteristics with single breath inhaled induction of anaesthesia. Anesth Analg 1996; 82(3):528–32.

    Article  PubMed  CAS  Google Scholar 

  11. Black A, Sury MRJ, Hemington L, Howard R, Mackersie A. A comparison of the induction characteristics of sevoflurane and halothane in children. Anaesthesia 1996; 51:539–542.

    Article  PubMed  CAS  Google Scholar 

  12. Yasuda N, Lockhart SH, Eger II EI, Weiskopf Richard B, Liu J. Comparison of kinetics of sevoflurane and isoflurane in humans. Anesth Analg 1991; 72:316–24.

    Article  PubMed  CAS  Google Scholar 

  13. Searle MR, Martineau RJ, Conzen P et al. Comparison of sevoflurane / fentanyl and isoflurane / fentanyl during elective coronary artery bypass surgery. Can J Anaesth 1996; 43(9):890–9.

    PubMed  CAS  Google Scholar 

  14. Malan TP, DiNardo JA, Isner RJ, Frink EJ, Goldberg M. Cardiovascular effects of sevoflurane compared with those of isoflurane in volunteers. Anesthesiology 1995; 83(5):918–28.

    Article  PubMed  CAS  Google Scholar 

  15. Elbert TJ. Cardiovascular and autonomic effects of sevoflurane. Acta Anaesthesiol Belg 1996; 47(1):15–21.

    Google Scholar 

  16. Inada T, Inada K, Kawachi S, Takubo K, Tai M, Yasugi H. Haemodynamic comparison of sevoflurane and isoflurane anaesthesia in surgical patients. Can J Anesth 1997; 44(2):140–145.

    Article  PubMed  CAS  Google Scholar 

  17. Mori N, Suzuki M, Sevoflurane in paediatric anaesthesia: Effects of respiration and circulation during induction and recovery. Paediatric Anaesthesia 1996; 6(2):95–102.

    Article  PubMed  CAS  Google Scholar 

  18. Lerman J, Sikich Nancy, Klienman S, Yentis S. The pharmacology of Sevoflurane in infants and children. Anesthesiology 1994; 80:814–24.

    Article  PubMed  CAS  Google Scholar 

  19. Cook DR, Davis PJ. Paediatric anesthesia pharmacology. In Carol L. Lake ed: Paediatric cardiac anaesthesia, 33d ed. Connecticut. Appleton and Lange 1998; pg.130.

  20. Koblin DD. Mechanism of action. In: Ronald D Miller, ed. Anesthesia 4th ed. New York: Churchill Livingstone Inc, 1994, 68.

  21. Kaufman L, Taberner PV. Pharmacology in the practice of anaesthesia. London, Edward Arnold 1996; pg. 51-52.

  22. Murray JM, Fee JPH. Volatile anaesthetic drugs. In: McCaughey W, Clarke RSJ, Fee JPH, Wallace WFM. Anaesthetic Physiology and Pharmacology, New York: Churchill Livingstone Inc, 1997; 165.

    Google Scholar 

  23. Stoelting RK, Langneckes DE. Effect of right to left shunt on rate of increase in arterial anaesthetic concentration. Anesthesiology 1972; 36:352–356.

    Article  PubMed  CAS  Google Scholar 

  24. Tanner GE, Angers DG, Barash PG et al. Effect of left to right, mixed left to right and right to left shunts on inhalational anaesthetic induction in children. A computer model. Anaesth Analg 1985; 64:101–7.

    Article  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Cardiac Anaesthesia, AI1MS, Ansari Nagar, 110029, New Delhi

    U Kiran MD (Additional Professor), N Saxena MD & N Raizada MD

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  1. U Kiran MD
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  2. N Saxena MD
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  3. N Raizada MD
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Correspondence to U Kiran MD.

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Kiran, U., Saxena, N. & Raizada, N. Tidal breathing technique for induction of anaesthesia with high concentration of sevoflurane, isoflurane or halothane in infants undergoing cardiac surgery. Indian J Thorac Cardiovasc Surg 17, 233–237 (2001). https://doi.org/10.1007/s12055-001-0022-0

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  • DOI: https://doi.org/10.1007/s12055-001-0022-0

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