Minimum alveolar concentration of desflurane with fentanyl for laryngeal mask airway removal in anesthetized children.
BACKGROUND
Desflurane provides rapid emergence from anesthesia. So, it can be used for the removal of a laryngeal mask airway in an anesthetized child. We conducted this study to determine the optimal endtidal concentrations of desflurane with fentanyl that would allow removal of a laryngeal mask airway without airway complication in children.


METHODS
Thirty-six children of American Society of Anesthesiologist status I between 1 and 10 year of age undergoing ophthalmic surgery were recruited. General anesthesia was induced with sevoflurane and oxygen given via mask and laryngeal mask airway inserted. Anesthesia was maintained with desflurane in 100% oxygen. At the end of the surgery, predetermined target concentration was maintained for 10 min and laryngeal mask airway removed. Each target concentration at the time of removal was predetermined by the Dixon up-down method (with 0.5% as a step size) starting at 5% endtidal concentration. A removal accomplished without coughing, teeth clenching, gross purposeful movement, breath holding, or laryngospasm, during or within 1 min after removal, was considered to be successful.


RESULTS
Endtidal concentration of desflurane required for successful laryngeal mask airway removal in 50% (ED50) was 3.56% desflurane (95% confidence limits, 3.22-3.87%) along with fentanyl.


CONCLUSIONS
Removal of laryngeal mask airway can be safely accomplished without coughing, moving, or any other airway complications at 3.57% endtidal concentrations of desflurane with fentanyl in 50% of anesthetized children.
Department of Anaesthesia and Intensive Care, Post Graduate Institute of Medical Education and Research, Chandigarh, India. jeet1516@gmail.com
Jeetinder K
JK
Makkar
Babita
B
Ghai
Neerja
N
Bhardwaj
Jyotsna
J
Wig
D000768:Anesthesia, General; D018685:Anesthetics, Inhalation / Q000008:administration & dosage*; D018686:Anesthetics, Intravenous / Q000008:administration & dosage*; D002648:Child; D002675:Child, Preschool; D003371:Cough / Q000209:etiology; D000077335:Desflurane; D004305:Dose-Response Relationship, Drug; D017558:Elective Surgical Procedures; D005143:Eyelids / Q000601:surgery; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage*; D006801:Humans; D007223:Infant; D007530:Isoflurane / Q000008:administration & dosage / Q000031:analogs & derivatives*; D017214:Laryngeal Masks; D007826:Laryngismus / Q000209:etiology; D016015:Logistic Models; D008297:Male; D016343:Monitoring, Intraoperative; D009068:Movement; D009609:Nitrous Oxide; D013508:Ophthalmologic Surgical Procedures; D010100:Oxygen / Q000097:blood; D011650:Pulmonary Alveoli; D016896:Treatment Outcome
D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D000077335:Desflurane; D007530:Isoflurane; D009609:Nitrous Oxide; D010100:Oxygen; D005283:Fentanyl