Abstract:
UNLABELLED:We sought to determine minimum alveolar anesthetic concentrations for skin incision (MAC) and for tracheal extubation (MAC(Ex)) for sevoflurane and its associated awakening time and respiratory complications during emergence from sevoflurane anesthesia in children. We studied 40 (20 in each group) unpremedicated pediatric patients ranging in age from 2 to 8 yr. For MAC(Ex) determination, anesthetic induction, tracheal intubation, and maintenance of anesthesia were performed with sevoflurane and N2O in oxygen. However, N2O administration was discontinued at the end of surgery. The ratio of the predetermined end-tidal to inspiratory concentration was maintained at 0.95-1.00 for at least 15 min. The trachea was gently extubated, and smooth tracheal extubation was defined by the absence of gross purposeful muscular movements. In addition, the respiratory complications and awakening time were investigated during emergence from anesthesia for each patient. For MAC determination, anesthesia induction and tracheal intubation were performed with 5% sevoflurane in oxygen. After the predetermined end-tidal sevoflurane concentration had been established and maintained for at least 15 min, skin incision was attempted. Patients' responses to skin incision were described as "no movement" or "movements." The MAC or MAC(Ex) for sevoflurane was 2.22% +/- 0.13% (mean+/-SD) or 1.70%+/-0.12%, and the 95% effective dose (ED95) for smooth extubation was 1.87% (95% confidence limits 1.75%-2.62%), respectively, in children. During emergence from anesthesia, none of patients held their breath or experienced laryngospasm in the current study. One patient in a subgroup at 1.5% coughed before tracheal extubation. All 10 patients with smooth tracheal extubation had hemoglobin oxygen saturation levels of > or =98% in this study. Awakening time was 9.7+/-3.7 min in the subgroup that received 1.75% sevoflurane. In conclusion, the MAC(Ex) and ED95 values of sevoflurane were 1.64% and 1.87%, respectively, in children. The MAC(Ex) to MAC ratio for sevoflurane was 0.8 in children within the same age range and mean age. IMPLICATIONS:Because tracheal extubation of anesthetized patients may be advantageous in certain clinical situations, we performed this study. The ratio minimum alveolar anesthetic concentrations for skin incision and for tracheal extubation for sevoflurane was 0.8 in children within the same age range and mean age. No patient in the current study had laryngospasm.
journal_name
Anesth Analgjournal_title
Anesthesia and analgesiaauthors
Inomata S,Suwa T,Toyooka H,Suto Ydoi
10.1097/00000539-199812000-00010subject
Has Abstractpub_date
1998-12-01 00:00:00pages
1263-7issue
6eissn
0003-2999issn
1526-7598journal_volume
87pub_type
杂志文章abstract::Large doses of morphine sulfate have been reported to cause myocardial lactate production and reduction in coronary blood flow in animals. Similar effects with clinical doses in man would significantly alter the management of cardiac patients. Eleven adult patients with significant coronary arterial disease and normal...
journal_title:Anesthesia and analgesia
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pub_type: 杂志文章,随机对照试验
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journal_title:Anesthesia and analgesia
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journal_title:Anesthesia and analgesia
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pub_type: 杂志文章
doi:10.1213/00000539-199412000-00011
更新日期:1994-12-01 00:00:00
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journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1989-03-01 00:00:00
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journal_title:Anesthesia and analgesia
pub_type: 杂志文章,随机对照试验
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pub_type: 临床试验,杂志文章,随机对照试验
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pub_type: 临床试验,杂志文章
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journal_title:Anesthesia and analgesia
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journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/00000539-199306000-00010
更新日期:1993-06-01 00:00:00
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journal_title:Anesthesia and analgesia
pub_type: 杂志文章
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journal_title:Anesthesia and analgesia
pub_type: 杂志文章
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journal_title:Anesthesia and analgesia
pub_type: 杂志文章
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journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:
更新日期:1980-02-01 00:00:00
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