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Sevoflurane Washin With the Dräger Apollo and GE Datex Ohmeda Aisys Workstations in Healthy Children
Jerrold Lerman1,2, Ana Maria Restrepo Correa3
1Department of Anesthesiology, John R. Oishei Children's Hospital, Buffalo, New York, USA.
Insights
The Dräger Apollo workstation demonstrated a slower sevoflurane wash-in profile and achieved lower maximum concentrations in pediatric anesthesia compared to the Ohmeda Aisys. This finding is crucial for optimizing anesthetic delivery in children.
Area of Science:
- Anesthesiology
- Pediatric Anesthesia
- Pharmacokinetics
Background:
- Sevoflurane is a preferred anesthetic agent for pediatric induction due to its favorable wash-in characteristics and minimal airway reactivity.
- Optimizing anesthetic delivery in pediatric patients is critical for patient safety and procedural success.
Purpose of the Study:
- To compare the sevoflurane wash-in profiles between the Dräger Apollo and Ohmeda Aisys anesthesia workstations in children.
- To evaluate differences in anesthetic gas delivery and uptake during induction.
Main Methods:
- A prospective observational study involving 24 healthy children undergoing elective surgery.
- Inhalational induction with 8% sevoflurane and 66% nitrous oxide was performed using either the Dräger Apollo or Ohmeda Aisys workstation.
- Inspired and end-tidal sevoflurane concentrations were meticulously recorded to derive wash-in metrics.
Main Results:
- The Dräger Apollo workstation exhibited significantly lower mean inspired sevoflurane concentrations compared to the Ohmeda Aisys.
- At 1 minute, inspired sevoflurane with the Apollo was 22% lower than with the Aisys.
- The time to reach 90% of maximum inspired sevoflurane concentration was 3.5-fold longer with the Apollo.
Conclusions:
- The Dräger Apollo workstation demonstrates a slower sevoflurane wash-in and achieves lower maximum concentrations in pediatric patients compared to the Ohmeda Aisys.
- These findings suggest potential differences in anesthetic gas delivery efficiency between the two workstations.
- Further research may explore clinical implications for anesthetic management in pediatric populations.
Background:
Sevoflurane is preferred for induction of anesthesia in children because of its rapid wash-in and minimal airway reactivity.
Aims:
The primary aim of this study was to compare the washin profiles of sevoflurane in children using the Dräger Apollo and Ohmeda Aisys workstations.
Methods:
Twenty-four healthy children (12 per workstation) scheduled for elective surgery underwent inhalational inductions with 8% sevoflurane and 66% nitrous oxide in this prospective observational study. The inspired and end-tidal sevoflurane concentrations were recorded every 30 for the first 5 min and every minute thereafter until the airway was secured. Primary and secondary outcomes consisted of the derived wash-in metrics during the induction.
Results:
The end-tidal to inspired ratios of sevoflurane were similar with both workstations. The mean (±SD) inspired sevoflurane concentrations with the Apollo were less than with the Aisys workstation (p < 0.013). The mean (±SD) inspired concentration at 1 min with the Apollo, 6.4% ± 0.4%, was 22% less than that with the Aisys, 7.8% ± 0.67% (mean difference 1.4, 95% CI 0.88 to 1.8, p < 0.0001). The mean (±SD) maximum inspired and expired sevoflurane concentrations during the induction period with the Apollo, 7.2% ± 0.3% and 6.8% ± 0.37%, were 18% and 15% less than those with the Aisys, 8.5% ± 0.4% and 7.8% ± 0.9%, (mean difference 1.3, 95% CI 0.99 to 1.6, p < 0.0001) and (mean difference 1.01, 95% CI 0.41 to 1.6, p < 0.002) respectively. The median (25-75th percentile) time to reach 90% of the maximum inspired concentration during the induction with the Apollo, 1.75 (1-2.4) min was 3.5-fold greater than that with the Aisys, 0.5, 0.5-0.5 min (median difference -1.25, 95% CI -1.5 to -0.5, p < 0.0019).
Conclusions:
The washing of sevoflurane with the Dräger Apollo workstation is slower, and the maximum sevoflurane concentrations are less in children than with the Ohmeda Aisys workstation.
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