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Sevoflurane EC50 and EC95 values for laryngeal mask insertion and tracheal intubation in children

R Aantaa1, R Takala, P Muittari

  • 1Department of Anaesthesiology and Intensive Care and Paediatric Surgery, Turku University, Finland.

British Journal of Anaesthesia
|September 28, 2001
PubMed

Insights

Laryngeal mask airway (LMA) insertion in children requires less sevoflurane anesthesia compared to tracheal intubation. This study determined the effective sevoflurane concentrations for successful airway control using both methods in pediatric patients.

Area of Science:

  • Anesthesiology
  • Pediatric Anesthesia
  • Airway Management

Background:

  • The laryngeal mask airway (LMA) is a recognized safe and effective tool for pediatric airway management.
  • Compared to laryngoscopy and tracheal intubation, LMA insertion requires less anesthetic and results in fewer adverse effects.

Purpose of the Study:

  • To determine the end-tidal concentrations of sevoflurane required for 50% (EC50) and 95% (EC95) success rates in securing the airway using LMA versus laryngoscopy and tracheal intubation in children.
  • To compare the anesthetic requirements for LMA insertion and tracheal intubation under sevoflurane anesthesia in pediatric patients.

Main Methods:

  • A randomized study involving 40 children (aged 4-12 years) undergoing general surgery.
  • Children were assigned to either LMA insertion (n=20) or laryngoscopy and tracheal intubation (n=20) under sevoflurane anesthesia.
  • Sevoflurane end-tidal concentrations were incrementally adjusted based on patient response, with logistic regression used to calculate EC50 and EC95 values.

Main Results:

  • Sevoflurane provided adequate conditions for both LMA insertion and tracheal intubation without significant adverse events.
  • The EC50 and EC95 for LMA insertion were 1.57% and 2.22%, respectively.
  • The EC50 and EC95 for laryngoscopy and tracheal intubation were 2.20% and 2.62%, respectively, indicating lower sevoflurane requirements for LMA.

Conclusions:

  • Laryngeal mask airway insertion in children requires significantly less sevoflurane compared to laryngoscopy and tracheal intubation.
  • Sevoflurane is a safe and effective anesthetic agent for both LMA insertion and tracheal intubation in the pediatric population.
  • These findings support the use of LMA as an efficient airway management technique in children, potentially reducing anesthetic agent usage.

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