[Comparative study of sevoflurane and nitrous oxide versus halothane and nitrous oxide in pediatric anesthesia: efficacy and hemodynamic characteristics during induction].
OBJECTIVE
To study the efficacy, side effects and hemodynamics of anesthetic induction in pediatric patients using sevoflurane and nitrous oxide or halothane and nitrous oxide.


METHODS
We studied 80 pediatric ASA I-II patients aged between 1 and 10 years old scheduled for infraumbilical surgery of short duration. The patients were randomly assigned to two groups of 40 to receive one of the two drug combinations. All the children were premedicated with nasal midazolam 0.2 mg.kg-1. Induction was by inhalation of increasing concentrations of sevoflurane or halothane. The maximum inspired concentration during induction was 7% for sevoflurane and 3% for halothane. We analyzed induction time, side effects and hemodynamic variables.


RESULTS
The induction time was 2.06 +/- 0.5 min for halothane and 1.6 +/- 0.6 min for sevoflurane (p < 0.01). We observed no differences between the groups in coughing, laryngospasm, bronchospasm, secretions, apnea, nausea, vomiting, agitation or hiccoughing. Supraventricular beats appeared in 22.5% of patients in the halothane group and in 5% of the sevoflurane group. Induction with both anesthetics caused significant decreases from baseline blood pressure levels but no significant changes in heart rate.


CONCLUSIONS
Inhaled sevoflurane in 60% nitrous oxide provides rapid but gentle anesthetic induction, with hemodynamic stability and a low incidence of airway complications. Sevoflurane is therefore a reasonable alternative to halothane for pediatric surgery.
Calderón
E
E
Servicio de Anestesiología-Reanimación y Terapéutica del Dolor, Hospital Universitario Puerta del Mar. Cádiz.
Torres
L M
LM
Aguado
J A
JA
de Antonio
P
P
Mora
R
R
Almarcha
J M
JM
D000769:Anesthesia, Inhalation; D019162:Anesthetics, Combined; D018685:Anesthetics, Inhalation / Q000494:pharmacology*; D002648:Child; D002675:Child, Preschool; D006221:Halothane / Q000494:pharmacology*; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D007223:Infant; D008738:Methyl Ethers / Q000494:pharmacology*; D009609:Nitrous Oxide / Q000494:pharmacology*; D000077149:Sevoflurane
D019162:Anesthetics, Combined; D018685:Anesthetics, Inhalation; D008738:Methyl Ethers; D000077149:Sevoflurane; D009609:Nitrous Oxide; D006221:Halothane
Estudio comparativo entre sevoflurano-óxido nitroso y halotano-óxido nitroso en anestesia pediátrica: eficacia y características hemodinámicas durante la inducción.