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[Comparison of intubating condition under sevoflurane and halothane anesthesia in pediatric patients]
Insights
Halothane anesthesia provided superior intubating conditions compared to sevoflurane anesthesia in pediatric patients undergoing otorhinolaryngological surgery. This study found halothane resulted in better vocal cord visibility and comparable body movement during intubation.
Area of Science:
- Anesthesiology
- Pediatric Surgery
- Pharmacology
Background:
- Optimizing intubating conditions is crucial for patient safety in pediatric surgery.
- Sevoflurane and halothane are commonly used anesthetic agents in pediatric populations.
- Comparative data on intubating conditions between sevoflurane and halothane in pediatric otorhinolaryngological surgery are limited.
Purpose of the Study:
- To compare the intubating conditions provided by sevoflurane versus halothane anesthesia in pediatric patients undergoing otorhinolaryngological surgery.
- To evaluate the impact of each anesthetic agent on mouth opening, vocal cord visibility, and body movement during intubation.
Main Methods:
- A randomized controlled trial involving 106 pediatric patients undergoing otorhinolaryngological surgery.
- Patients were allocated to either sevoflurane (group S, n=60) or halothane (group H, n=46) anesthesia.
- Intubating conditions were assessed using a standardized intubation score evaluating mouth opening, vocal cord visibility, and body movement.
Main Results:
- Halothane anesthesia (group H) resulted in significantly better intubating conditions compared to sevoflurane anesthesia (group S).
- Vocal cord visibility was significantly poorer in the sevoflurane group (group S) compared to the halothane group (group H).
- Body movement during intubation was similar between the two groups (27% in group S vs. 26% in group H).
Conclusions:
- Halothane anesthesia offers superior intubating conditions compared to sevoflurane anesthesia in pediatric patients undergoing slow induction for otorhinolaryngological procedures.
- Anesthesiologists should consider halothane for improved intubation ease and safety in this specific pediatric surgical context.
Abstract:
We compared intubating conditions under sevoflurane (group S) and halothane (group H) anesthesia in pediatric patients for otorhinolaryngological surgery. One hundred and six patients were divided randomly into group S (n = 60) and group H (n = 46). Anesthesia was induced with nitrous oxide-oxygen-sevoflurane (GOS, end-tidal sevoflurane concentration; 4.5%) or nitrous oxide-oxygen-halothane (GOF, end-tidal halothane concentration; 1.6%). Intubating conditions were assessed according to the intubation score, which consists of the following three factors; mouth opening, visibility of vocal cord and body movement. Each factor is divided into three grades (0, 1, 2); total scores of 0 correspond to excellent. In comparing the groups with respect to anesthetic induction, group S required 180 sec for disappearance of spontaneous breathing and 660 sec for completion of intubation, while, in group H, the above time intervals were 188 and 676 sec, respectively. We achieved significantly better intubating conditions in group H than group S. There were significantly more cases in group S than in group H in which vocal cord visibility was insufficient. Body movement during intubation was observed in 27% and 26% of patients in group S and H, respectively. In conclusion, halothane anesthesia provides better intubating conditions than sevoflurane anesthesia in slow induction for pediatric patients.