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A clinical trial of enflurane in children
Insights
Enflurane anesthesia in children demonstrated rapid induction and recovery for elective surgeries. This agent is best suited for short pediatric anesthetics with spontaneous respiration.
Area of Science:
- Anesthesiology
- Pediatric Medicine
- Pharmacology
Background:
- Enflurane is an inhalation anesthetic.
- Its use in pediatric anesthesia requires careful evaluation.
Purpose of the Study:
- To evaluate the efficacy and safety of enflurane as a primary anesthetic agent in children undergoing elective surgery.
Main Methods:
- Administered enflurane to 200 children (7 months to 14 years) for elective surgery.
- Monitored cardiovascular changes, respiratory parameters (end-tidal CO2), liver function, and muscle relaxation.
- Observed electroencephalogram (EEG) changes in cases of poor relaxation.
Main Results:
- Enflurane provided rapid induction and recovery with generally uneventful anesthesia.
- Observed transient hypotension, supraventricular arrhythmias, and elevated end-tidal CO2 during spontaneous ventilation.
- Achieved satisfactory muscle relaxation in most cases without muscle relaxants; noted poor relaxation in two cases with associated EEG changes.
Conclusions:
- Enflurane is suitable for short-duration pediatric anesthesia with spontaneous respiration.
- Further investigation is warranted for specific phenomena like EEG changes observed during poor relaxation.
Abstract:
Enflurane was administered as the primary anaesthetic agent to 200 children between the ages of 7 months and 14 years who were undergoing elective surgery. Induction and recovery were rapid and generally uneventful. Changes observed in the cardiovascular system included an initial fall in blood pressure, which tended subsequently to correct itself, and supraventricular arrhythmias mainly of nodal rhythm type. End expiratory CO2-concentration as measured by a capnograph tended to be elevated during spontaneous ventilation . Changes in liver function as measured by enzymatic activity were seen in some cases but were without statistical significance. Satisfactory muscle relaxation was generally obtained without the use of muscle relaxants. However, in two cases, poor relaxation occurred even at a concentration of 4.5% enflurane, and in these cases, EEG changes of polyspike suppression type were observed. This phenomenon is discussed in a subsequent article. As a result of their findings, the authors conclude that in paediatric anaesthesia enflurane is best suited for use in anaesthetics of relatively short duration with spontaneous respiration.