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50% effective concentration of sevoflurane for immobility in cerebral palsy children undergoing botulinum toxin

Kanghui Kim1, Eunhee Lee, Sung Mee Jung

  • 1Department of Anesthesiology and Pain Medicine, Yeungnam University College of Medicine, Daegu, Republic of Korea.

Medicine
|October 25, 2022
PubMed

Insights

The optimal end-tidal sevoflurane concentration for immobile botulinum toxin injections in children with cerebral palsy (CP) is 1.76%. This concentration ensures successful procedures in 50% of pediatric patients undergoing treatment.

Area of Science:

  • Anesthesiology
  • Pediatric Medicine
  • Neurology

Background:

  • Cerebral palsy (CP) affects children's motor functions, often necessitating treatments like botulinum toxin injections.
  • Immobility is crucial for the success of botulinum toxin injections, especially in pediatric patients.

Purpose of the Study:

  • To determine the optimal end-tidal sevoflurane concentration for achieving immobility during botulinum toxin injections.
  • To establish the effective concentration (EC50) of sevoflurane for this specific pediatric procedure.

Main Methods:

  • A prospective study involving 23 children (aged 3-12 years) with spastic CP.
  • Modified Dixon's up-and-down method was used to determine end-tidal sevoflurane concentration for immobility.
  • Botulinum toxin type A injections were administered to spontaneously breathing children under sevoflurane sedation.

Main Results:

  • The 50% effective end-tidal concentration (EC50) of sevoflurane for immobility was found to be 1.76% ± 0.15%.
  • Probit analysis predicted EC50 at 1.77% and the 95% effective concentration (EC95) at 2.09% for immobility.
  • 57.1% of the children achieved "no movement" during the injection at the determined concentrations.

Conclusions:

  • Botulinum toxin injections can be safely and effectively performed in spontaneously breathing children with CP using a specific sevoflurane concentration.
  • An end-tidal sevoflurane concentration of 1.76% ± 0.15% is effective for achieving immobility in 50% of pediatric patients with CP undergoing botulinum toxin injections.
Abstract

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