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Anaesthetic induction time for tracheal intubation using sevoflurane or halothane in children
S Inomata1, S Yamashita, H Toyooka
1Department of Anaesthesia, Institute of Clinical Medicine, University of Tsukuba, Ibaraki, Japan.
Insights
Sevoflurane (5%) and halothane (2.5%) allow for anesthetic induction time determination for tracheal intubation in children. Sevoflurane appears more practical for pediatric anesthesia induction in clinical settings.
Area of Science:
- Anesthesiology
- Pediatric Anesthesia
- Pharmacology
Background:
- Determining anesthetic induction time is crucial for safe tracheal intubation in pediatric patients.
- Equipotent concentrations of sevoflurane and halothane are commonly used for inhalation anesthesia.
Purpose of the Study:
- To determine the anesthetic induction time (TimeEI) for tracheal intubation using equipotent inspired concentrations of sevoflurane (5%) and halothane (2.5%) in oxygen.
- To define TimeEI50 and TimeEI95, representing times to prevent 50% and 95% of patients from coughing and gross purposeful muscular movements.
Main Methods:
- A prospective study involving 36 pediatric patients aged 1-7 years.
- Anesthesia was induced via mask with predetermined TimeEI values.
- The up-and-down method was used to determine TimeEI for tracheal intubation with uncuffed tubes.
- Smooth intubation was defined as intubation without gross purposeful muscular movements.
Main Results:
- The determined TimeEI50 for sevoflurane and halothane groups were 147 seconds and 214 seconds, respectively.
- The determined TimeEI95 for sevoflurane and halothane groups were 194 seconds and 255 seconds, respectively.
- Both agents allowed for the determination of TimeEI for tracheal intubation.
Conclusions:
- Anesthetic induction time for tracheal intubation can be determined using 5% sevoflurane or 2.5% halothane in oxygen.
- The 5% sevoflurane technique appears more practical for pediatric anesthesia induction in demanding clinical environments.
Abstract:
The current study was designed to determine the anaesthetic induction time required for tracheal intubation (TimeEI) with equipotent inspired concentrations of 5% sevoflurane and 2.5% halothane in oxygen. TimeEI that prevents 50% and 95% of patients from coughing and gross purposeful muscular movements after intubation was defined as TimeEI50 and TimeEI95, respectively. Thirty-six patients aged 1-7 years were enrolled in the study. Anaesthesia was induced via mask and when TimeEI attained a predetermined value, intubation was performed using an uncuffed tube. Each TimeEI at which tracheal intubation was attempted was predetermined according to the up-and-down method. When intubation was accomplished without gross purposeful muscular movements, it was considered a smooth intubation. Determination with this method revealed that TimeEI50 and TimeEI95 for the sevoflurane/halothane groups were 147/214 s and 194/255 s, respectively. In conclusion, it is possible to determine TimeEI using an inspired sevoflurane concentration of 5% and halothane 2.5% in oxygen. The technique with 5% sevoflurane seems more practical for paediatric anaesthesia induction in busy clinical situations.