Early intravenous cannulation in children during sevoflurane induction.
BACKGROUND
It has been shown that early placement of an intravenous line in children anesthetized with halothane is equally safe compared with later placement. Whether this is true of sevoflurane is not known.


METHODS
Pediatric patients, age 1-18 years, undergoing elective general anesthesia via an inhalation induction were randomized to intravenous placement either 30 or 120 s following loss of lid reflex. Movement on intravenous placement and incidence of laryngospasm were determined. Difficulty with intravenous placement was recorded.


RESULTS
Movement on intravenous placement was more prevalent in the early group than in the late group (P < 0.0001). There was no laryngospasm in the late group and eight cases in the early group (P < 0.004). Children who had laryngospasm were older (P < 0.02) and weighed more (P < 0.04). Older children in the early group were more likely to have significant movement.


CONCLUSIONS
Following an inhalation induction with sevoflurane in children, movement with intravenous placement was greater, and the incidence of laryngospasm was higher, when the intravenous access was attempted 30 s rather than 120 s following loss of lid reflex. We recommend waiting two min following the loss of lid reflex before attempting intravenous placement in children receiving an inhalation induction with sevoflurane.
Schwartz
Donald
D
Department of Anesthesiology, Baystate Medical Center, Springfield, MA 01199, USA.
Connelly
Neil Roy
NR
Gutta
Srinivasa
S
Freeman
Katharine
K
Gibson
Charles
C
D000293:Adolescent; D000769:Anesthesia, Inhalation; D018685:Anesthetics, Inhalation; D002404:Catheterization; D002648:Child; D002675:Child, Preschool; D005143:Eyelids / Q000502:physiology; D005260:Female; D006801:Humans; D007223:Infant; D007431:Intraoperative Complications / Q000453:epidemiology; D007826:Laryngismus / Q000453:epidemiology; D008297:Male; D008738:Methyl Ethers; D016343:Monitoring, Intraoperative; D000077149:Sevoflurane
D018685:Anesthetics, Inhalation; D008738:Methyl Ethers; D000077149:Sevoflurane