title: Optimal dose of sufentanil in children for intubation after sevoflurane induction without neuromuscular block.
abstract: BACKGROUND
  We studied 63 ASA I children (age 2-8 yr) to determine the sufentanil dose needed to facilitate intubation under excellent conditions after inhalation induction with various end-tidal concentrations of sevoflurane without neuromuscular block.
  
  
  METHODS
  Subjects were allocated randomly to receive sevoflurane end-tidal concentrations (e'(sevo)) of 2.5%, 3%, or 3.5%. Anaesthesia was induced with sevoflurane 6% without nitrous oxide for 2 min, and then inspired sevoflurane concentration was adjusted to keep e'(sevo) at 2.5%, 3%, or 3.5% according to the group. Subjects received i.v. sufentanil according to an 'up and down' design. Tracheal intubation by direct laryngoscopy was performed 6 min after sufentanil injection. Intubation was considered successful, if intubation conditions were excellent as determined by the laryngoscopist.
  
  
  RESULTS
  The ED(50) [effective dose for 50% of subjects; mean (sd)] of sufentanil required for excellent intubation conditions was 0.6 (0.12), 0.32 (0.10), or 0.11 (0.07) microg kg(-1) for e'(sevo) of 2.5%, 3%, or 3.5%, respectively. Using logistic analysis, the 95% effective dose (ED(95)) of sufentanil was 1.02 [95% confidence intervals (CI) 0.31-1.74] microg kg(-1), 0.58 (95% CI 0.17-0.99) microg kg(-1), or 0.28 (95% CI 0.04-0.52) microg kg(-1) for e'(sevo) of 2.5%, 3%, or 3.5%, respectively.
  
  
  CONCLUSIONS
  Excellent intubation conditions could be obtained in children after inhalation induction with low sevoflurane concentrations and adjuvant sufentanil.
authors.affiliation: Département d'Anesthésie-Réanimation IV, Hôpital Pellegrin, 33076 Bordeaux cedex, France. alexis.soulard@chu-bordeaux.fr
authors.forename: A
authors.initials: A
authors.lastname: Soulard
authors.forename: F
authors.initials: F
authors.lastname: Babre
authors.forename: M
authors.initials: M
authors.lastname: Bordes
authors.forename: Y
authors.initials: Y
authors.lastname: Meymat
authors.forename: F
authors.initials: F
authors.lastname: Sztark
authors.forename: A M
authors.initials: AM
authors.lastname: Cros