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Inhalation agents in pediatric anaesthesia - an update
1Women and Children's Hospital of Buffalo, SUNY, Strong Memorial Hospital, University of Rochester, Rochester, New York, USA. jerrold.lerman@gmail.com
Current Opinion in Anaesthesiology
|May 5, 2007
Summary
Recent studies highlight inhaled anesthetics like sevoflurane and desflurane for pediatric care. Medications can manage emergence delirium, but caution is advised for children with Duchenne
Area of Science:
- Pediatric Anesthesiology
- Inhalational Anesthetics
- Clinical Pharmacology
Background:
- Inhaled anesthetics are crucial for pediatric anesthesia.
- Emergence delirium and specific patient conditions pose challenges.
- Recent advancements offer improved safety and efficacy.
Purpose of the Study:
- To review recent publications on inhaled agents in children.
- To discuss their implications for clinical practice.
- To highlight safety considerations and emerging techniques.
Main Methods:
- Literature review of recent publications.
- Analysis of clinical findings related to inhaled anesthetics.
- Discussion of pharmacologic interventions and monitoring.
Main Results:
- Clonidine, dexmedetomidine, ketamine, and nalbuphine aid in managing emergence delirium.
- Bispectral index monitoring reveals unique findings with different agents.
- Sevoflurane and desflurane require careful use in Duchenne muscular dystrophy patients due to risks of hyperkalemia and myocardial depression.
- Desflurane offers faster recovery in pediatric patients.
- Single-breath inductions with sevoflurane are effective for rapid anesthesia induction in older children.
Conclusions:
- Sevoflurane and desflurane present ongoing challenges in pediatric anesthesia.
- Emergence delirium can be managed with specific medications.
- Caution is essential when using inhaled agents in children with Duchenne muscular dystrophy.
- Rapid recovery with desflurane and efficient induction with sevoflurane are notable advancements.
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