Abstract
Within 15 minutes of terminating general anaesthesia, progressive recovery of consciousness, spontaneous ventilation and cough, and limb movements were assessed in 60 young children (age range 0-5 years, mean ± SEM; 2.$3 ± 0.34; weight 13.86 ± 0.41 kg). All patients were ASA physical status class I-III, received a standard intravenous induction (atropine 0.02 mg·kg-1, thiopental sodium 5 mg·kg-1, diazepam 0.2mg·kg-1), were intubated with an orotracheat tube following the administration of metocurine, 0.4 mg·kg-1, and were maintained under general anaesthesia with nitrous oxide and oxygen in a 70:30 mixture administered by a T-piece circuit. They were ventilated mechanically to maintain normal blood- oxygen tension and normocarbia.
The patients were assessed in three equal groups according to the anaesthetic supplement they received. Group I received intravenous infusions of morphine sulfate (loading dose 60 μg·kg-1administered over 5 minutes followed by a continuous intravenous infusion of 2 μg·kg-1min-1. Patients in Groups II and HI had 0.5 per cent halothane and 1.0 per cent isoflurane respectively added to the nitrous oxidel oxygen fresh gas mixture rather than morphine sulphate infusions.
By the end of the study period, there was no significant difference in the degree of recovery between the morphine and the isoflurane groups but the patients in the halothane group had recovered to a lesser degree. Generally, the patients in the morphine group were awake but not crying, while those in the other two groups were less sedated.
Résumé
Cette étude a porté sur 60 jeunes enfants, de0à5 ans et pesant en moyenne 13.8 kilos, A moins de quinze minutes, à la suite d’anesthésies générales, nous avons évalué le retour progressif de la conscience et de la ventilation spontanée et avons noté la présence des mouvements des membres. Tous les enfants étaient de classe 1-3 A.S.A, et avaient reçu une induction intraveineuse normalisée constituée d’atropine à 0.02mg·kg-1 de thiopenthal sodique à 5 mg·kg-1 et de diazépam à 0.2 mg·kg-1. Tous ont été intubés par voie oro-trachéale et l’anesthésie entretenue avec du protoxide d’azote et de l’oxygène dont un mélange à 70/30 administré par un système avec pièces en T. Ils étaient ventilés mécaniquement pour maintenir les tensions d’oxygène et de CO2 à l’intérieur de la normale. Les malades ont été répartis en trois groupes (20 malades par groupe) selon la médication anesthésique adjuvante qu’ils ont reçue. Le groupe 1 a reçu des infusions intraveineuses de morphine. La dose d’amorce était de 60μg·kg-1 injectée sur une période de cinq minutes. Cette dose était suivie par l’infusion continue de 2μg·kg-1 par minute. Pour les malades du groupe II et III de l’halothane à 0.5 pour cent et de l’isoflurane à un pour cent respectivement ont été rajoutés au mélange des gaz frais.
A la fin de la période d’observation, les malades du groupe halothane étaient moins alertes que ceux des deux autres groupes. Il n’y avait pas de différence significative dans le degré d’éveil entre les malades du groupe morphine et isoflurane. En général, les malades du groupe morphine étaient éveillés mais ne pleuraient pas, alors que ceux des deux autres groupes apparaissaient moins calmes.
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This project was funded by an Ontario Provincial Health Research Grant, PR 932
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Chinyanga, H.M., Vandenberghe, H., MacLeod, S. et al. Assessment of immediate post-anaesthetic recovery in young children following intravenous morphine infusions, halothane, and isoflurane. Can Anaesth Soc J 31, 28–35 (1984). https://doi.org/10.1007/BF03011480
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DOI: https://doi.org/10.1007/BF03011480