Induction and recovery characteristics and hemodynamic responses to sevoflurane and halothane in children.
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)
Department of Anesthesia, Hôpital d'Enfants Armand Trousseau, Paris, France.
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Piat
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Dubois
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Johanet
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Murat
D000758:Anesthesia; D000777:Anesthetics / Q000494:pharmacology*; D002648:Child; D002675:Child, Preschool; D004987:Ethers / Q000494:pharmacology*; D006221:Halothane / Q000494:pharmacology*; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D007223:Infant; D008738:Methyl Ethers; D000077149:Sevoflurane
D000777:Anesthetics; D004987:Ethers; D008738:Methyl Ethers; D000077149:Sevoflurane; D006221:Halothane