Total intravenous anesthesia with etomidate. II. Evaluation of a practical technique for children

A practical technique for the administration of anesthesia to children is described, using only intravenous agents. Anesthesia was induced using etomidate 0.3 mg/kg, analgesia being provided by fentanyl or pentazocine, and muscle relaxation by suxamethonium or pancuronium. Unconsciousness was maintained by infusion of a 1% solution of etomidate given at a pre-determined rate of 30 microgram/kg/min. Paralysis was maintained throughout the period of surgical stimulation, in the majority of patients by continuous infusion of suxamethonium 0.1 mg/kg/min. The chosen rate of infusion of etomidate appears to be adequate to reliably maintain sleep in children, yet allow rapid recovery of consciousness when the infusion is stopped, thereby relieving the anesthetist of concern about these points. The maintenance of complete paralysis throughout operation removes the possibility of movement, the major cause of unsatisfactory anesthesia using only intravenous agents.