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Induction and recovery characteristics and hemodynamic responses to sevoflurane and halothane in children
V Piat1, M C Dubois, S Johanet
1Department of Anesthesia, Hôpital d'Enfants Armand Trousseau, Paris, France.
Insights
Sevoflurane anesthesia in children showed mild excitement, while halothane anesthesia caused laryngospasm and cardiovascular issues. Both anesthetic agents provided similar induction and recovery times.
Area of Science:
- Anesthesiology
- Pediatric Anesthesia
- Pharmacology
Background:
- Halothane has been a common anesthetic agent in pediatric patients.
- Sevoflurane is a newer inhaled anesthetic agent with a favorable profile.
Purpose of the Study:
- To compare the induction and recovery characteristics of sevoflurane and halothane anesthesia in children.
- To assess the hemodynamic profile of sevoflurane versus halothane during pediatric anesthesia.
Main Methods:
- A randomized study involving 34 children (9 months to 9 years) undergoing ambulatory surgery.
- Patients received either halothane or sevoflurane via mask for induction and maintenance of anesthesia.
- Epidural anesthesia was used for analgesia, and hemodynamic data were recorded.
Main Results:
- Sevoflurane group: five children experienced mild excitement. Halothane group: one child had mild laryngospasm and one showed transient cardiovascular deterioration.
- Sevoflurane led to a significant heart rate increase before intubation, with stable hemodynamics during maintenance.
- Halothane maintained stable heart rate but significantly decreased systolic arterial pressure during induction and maintenance.
Conclusions:
- Sevoflurane and halothane exhibit comparable induction and recovery profiles in pediatric patients.
- Sevoflurane appears to have a more stable hemodynamic profile compared to halothane during pediatric anesthesia.
Abstract:
The present study was designed to compare induction and recovery characteristics of sevoflurane and halothane anesthesia in children, and to assess the hemodynamic profile of both anesthetics during induction and maintenance of anesthesia. Thirty-four children (aged 9 mo-9 yr) scheduled for ambulatory surgery were allocated randomly to groups to receive either halothane (HALO, n = 17) or sevoflurane (SEVO, n = 17) in a mixture of O2 and N2O (40:60) for mask induction and maintenance of anesthesia. The inspired concentrations used for inhalation via a mask were increased every five breaths and were successively 1%, 2%, 3%, and 3.5% for HALO and 2%, 4%, 6%, and 7% for SEVO. After tracheal intubation, expired concentration was maintained at 1 minimum alveolar anesthetic concentration (MAC) corrected for age until skin closure. Analgesia was provided by epidural anesthesia using a mixture of plain 1% lidocaine and 0.25% bupivacaine. Induction and recovery characteristics as well as hemodynamic data were recorded. The two groups were identical in age, weight, and duration of anesthesia and surgery. Time to intubation was the same between groups. In the SEVO group, five children exhibited mild excitement, while in the HALO group, one mild laryngospasm and one transient cardiovascular deterioration were observed. In the SEVO group, a significant increase in heart rate (HR) was observed before tracheal intubation, but during maintenance of anesthesia HR and systolic arterial pressure (SAP) did not change compared to control values. In the HALO group, HR did not change throughout the study, whereas SAP remained significantly below control values throughout both induction and maintenance of anesthesia.(ABSTRACT TRUNCATED AT 250 WORDS)