title: Clinical effects of sevoflurane anesthesia induction with a portable inhalational anesthetic circuit in pediatric patients.
abstract: BACKGROUND
  Pediatric anesthesia induction with sevoflurane usually needs a special vaporizer and gas source, which limits its use to the operating room (OR). Many children feel anxious and cry when entering the OR because of being separated from their parents, which impairs anesthesia safety and their physical and mental health. In this study, we used a portable circuit to perform sevoflurane anesthesia induction outside the OR, assessed its effects and compared them with those of ketamine anesthesia in pediatric patients.
  
  
  METHODS
  One hundred children had anesthesia induced with either sevoflurane (sevoflurane group) through the portable inhalational anesthetic circuit, or ketamine by intramuscular injection (ketamine group), then were transferred to the OR. Peak inspired concentration (Cp) and steady state concentration (Cs) of sevoflurane were measured. Heart rate (HR) and saturation of peripheral oxygen (SpO2) were monitored. Time for anesthesia induction, awakening, leaving the OR and duration of the operation were recorded. The patients' reaction during anesthesia was also analyzed.
  
  
  RESULTS
  The Cp and Cs of sevoflurane were correlated with bodyweight. Compared with the ketamine group, the sevoflurane group showed shorter time for anesthesia induction (28 ±7 s vs. 195 ±34 s, p < 0.0001), awakening (11.2 ±3.6 s vs. 63.5 ±6.7 s, p < 0.0001) and leaving the OR (20.5 ±5.6 s vs. 43.4 ±10.6, p < 0.0001), less noncooperation during anesthesia induction (10% vs. 80%, p < 0.0001), lower HR (130 ±16 beats/min vs. 143 ±19 beats/min, p = 0.0004) and higher SpO2 (98.9 ±0.9% vs. 96.1 ±2.5%, p < 0.0001) on arrival at the OR.
  
  
  CONCLUSIONS
  Pediatric anesthesia induction by sevoflurane with the portable inhalational anesthetic circuit is convenient, safe and effective outside the OR.
authors: Department of Anesthesiology, the First Affiliated Hospital, Nanjing Medical University, Nanjing, China.
authors: Min
authors: M
authors: Yu
authors: Department of Anesthesiology, the First Affiliated Hospital, Nanjing Medical University, Nanjing, China.
authors: Chuanbao
authors: C
authors: Han
authors: Department of Anesthesiology, the First Affiliated Hospital, Nanjing Medical University, Nanjing, China.
authors: Qinhai
authors: Q
authors: Zhou
authors: Department of Anesthesiology, the First Affiliated Hospital, Nanjing Medical University, Nanjing, China.
authors: Cunming
authors: C
authors: Liu
authors: Department of Anesthesiology, the First Affiliated Hospital, Nanjing Medical University, Nanjing, China.
authors: Zhengnian
authors: Z
authors: Ding
keywords: anesthesia; pediatric surgery; sevoflurane