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PubMed · 15385025

Halothane, isoflurane and sevoflurane in pediatric anesthesia: can we decrease costs without increasing adverse events?

Alejandro A Nava-Ocampo·Juan M Alarcón-Almanza·Diana Moyao-García·Juan C Ramírez-Mora·Jorge Salmerón
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Anesthesia, InhalationAnesthetics, InhalationChildDrug CostsHalothaneHumansIsofluraneMethyl EthersMexicoSevofluraneLetterResearch Support, Non-U.S. Gov't

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Alejandro A Nava-Ocampo, Juan M Alarcón-Almanza, Diana Moyao-García, Juan C Ramírez-Mora, Jorge Salmerón. 2004. Halothane, isoflurane and sevoflurane in pediatric anesthesia: can we decrease costs without increasing adverse events?. https://doi.org/10.1111/j.1460-9592.2004.01434.x

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BACKGROUND: The value of the laryngeal tube S (LTS) for emergency airway management was evaluated in comparison to endotracheal intubation (ETI). METHODS: Physicians were asked to perform simulated airway management in an airway mannequin. The physicians were allocated into three groups according to their experience in intubation (1: <50, 2: >50, 3: >500 intubations). The success rate using LTS and ETI, the time needed for securing the airway, and the rating of both techniques by the participants were recorded. RESULTS: A correct position was achieved with the LTS in 99.39% of attempts (n=325), and with the endotracheal tube in 92.35% (n=302). Using the LTS it took an average time of 10.85 s to achieve the first successful ventilation, as compared to 17.75 s in ETI (p<0.0001). Participants from group 1 needed longer to achieve ETI in the 2nd (18.4 s vs. 16.4 s, p<0.0001) and 3rd attempts (16.9 s vs. 15.8 s, p<0.0001) compared to those from group 3. CONCLUSIONS: The LTS represents a fast and reliable method to secure the airway and to achieve ventilation in the mannequin model described. The success rate, the time until successful ventilation and the rating by the participants indicates that the LTS is an important alternative to ETI. The LTS offers special benefits for the less experienced users.

Anesthesia, Inhalation↗
PubMed2005

Anesthetic potency of sevoflurane with and without nitrous oxide in mechanically ventilated Dumeril monitors.

OBJECTIVE: To determine the minimum alveolar concentration (MAC) of sevoflurane and assess the sevoflurane-sparing effect of coadministration of nitrous oxide in mechanically ventilated Dumeril monitors (Varanus dumerili). DESIGN: Prospective crossover study. ANIMALS: 10 healthy adult Dumeril monitors. PROCEDURE: Anesthesia was induced with sevoflurane in 100% oxygen or sevoflurane in 66% nitrous oxide (N2O) with 34% oxygen, delivered through a face mask. Monitors were endotracheally intubated, and end-tidal and inspired isoflurane concentrations were measured continuously; MAC was determined by use of a standard bracketing technique. An electrical stimulus (50 Hz, 50 V) was delivered to the ventral aspect of the tail as the supramaximal stimulus. A blood sample for blood gas analyses was collected from the ventral coccygeal vessels at the beginning and end of the anesthetic period. An interval of at least 7 days was allowed to elapse between treatments. RESULTS: The MAC +/- SDs of sevoflurane in oxygen and with N2O were 2.51 +/- 0.46% and 1.83 +/- 0.33%, respectively. There was a significant difference between the 2 treatments, and the mean MAC-reducing effect of N2O was 26.4 +/- 11.4%. Assuming simple linear additivity of sevoflurane and N2O, the MAC for N2O was estimated to be 244%. No significant differences in blood gas values--with the predictable exception of oxygen pressure--were detected between the 2 groups. CONCLUSIONS AND CLINICAL RELEVANCE: The MAC of sevoflurane in Dumeril monitors is similar to that reported for other species. The addition of N2O significantly decreased the MAC of sevoflurane in this species.

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PubMed2005

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