Target-controlled inhalation induction with sevoflurane in children: a prospective pilot study.
BACKGROUND
Target-controlled inhalation induction (TCII) with sevoflurane is becoming possible with new anesthesia platforms. Although TCII has already been performed in adults, it remains to be evaluated in children.


METHODS
In a prospective study, we compared TCII using the Felix AInOC anesthetic station (Taema, Anthony, France) to our standard protocol inhalation induction in children scheduled for elective surgery under general anesthesia. After preoxygenation, sevoflurane induction was performed in both groups without priming of the circuit. Sufentanil was administered after venous line placement.


RESULTS
In the TCII group, no overdosage or underdosage was observed except in two children where TCII failed owing to high agitation, and the number of adjustments was lower compared with our standard protocol inhalation induction (1(1-2.5[0-5]) vs 6(5-6[4-10]) respectively). Moreover, the delay to obtain target end-tidal sevoflurane concentration was shorter in the TCII group (2(1.6-2.7[1.3-4]) min vs 3.4(2.5-3.8[2.3-6.5]) min respectively). No significant difference in the delay of loss of consciousness or in the conditions for intubation or laryngeal mask placement was observed between the groups.


CONCLUSIONS
The Felix AInOC allows TCII to be performed satisfactorily in children. Manual inhalation induction induced a higher number of adjustments and overdosages.
Fritsch
Nicolas
N
Department of anesthesia 4, Hôpital Pellegrin, CHU Bordeaux, Bordeaux, France.
Nouette-Gaulain
Karine
K
Bordes
Maryline
M
Semjen
Francois
F
Meymat
Yves
Y
Cros
Anne-Marie
AM
D000769:Anesthesia, Inhalation / Q000295:instrumentation* / Q000379:methods; D018685:Anesthetics, Inhalation / Q000008:administration & dosage*; D001794:Blood Pressure / Q000187:drug effects; D002648:Child; D002675:Child, Preschool; D016503:Drug Delivery Systems / Q000295:instrumentation* / Q000379:methods; D004360:Drug Therapy, Computer-Assisted; D004569:Electroencephalography / Q000187:drug effects; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007442:Intubation, Intratracheal / Q000379:methods; D008738:Methyl Ethers / Q000008:administration & dosage*; D010865:Pilot Projects; D011446:Prospective Studies; D000077149:Sevoflurane; D013990:Tidal Volume / Q000187:drug effects; D016896:Treatment Outcome
D018685:Anesthetics, Inhalation; D008738:Methyl Ethers; D000077149:Sevoflurane