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Similar haemodynamic, respiratory and metabolic changes with the use of sevoflurane or halothane in children breathing spontaneously via a laryngeal mask airway
Author(s) -
Erb T.,
Christen P.,
Kern C.,
Frei F. J.
Publication year - 2001
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1034/j.1399-6576.2001.045005639.x
Subject(s) - medicine , sevoflurane , anesthesia , halothane , hemodynamics , ventilation (architecture) , heart rate , respiratory rate , respiratory system , blood pressure , mechanical engineering , engineering
Background: In preschool children, short‐lasting surgical procedures are often performed under combined inhalational and regional anaesthesia with the child breathing spontaneously via a laryngeal mask airway (LMA). Despite widespread use, only limited data are available on haemodynamic, respiratory and metabolic effects of sevoflurane and halothane during LMA anaesthesia. Methods: In an open‐label, randomised, controlled study, 49 children (aged 3–8 years) were allocated to receive either sevoflurane or halothane in 60% nitrous oxide. After insertion of the LMA, end‐tidal concentrations of sevoflurane or halothane were maintained at 1 MAC with the child ventilating spontaneously throughout the entire procedure. Analgesia was provided by caudal block. Haemodynamic and respiratory parameters were recorded, and capillary blood‐gas samples were obtained repeatedly. Results: Changes in heart rate (HR) and systolic blood pressure were similar in both groups during all observed periods, apart from a significantly higher increase in HR during inhalational induction with sevoflurane ( P <0.05). Regression slope analysis during anaesthesia revealed a decrease of the respiratory rate of 5 breaths h −1 ( P <0.001) and an increase of end‐tidal PCO 2 and capillary PCO 2 of about 0.25 kPa h −1 ( P <0.001), with no significant difference between the two groups. Base excess, calculated in capillary blood gas samples, did not change over time ( P >0.5) in either group. Conclusions: The use of approximately 1 MAC sevoflurane or halothane in 60% N 2 O in children breathing spontaneously via LMA resulted in comparable haemodynamic, respiratory and metabolic changes, and clinically relevant deteriorations did not occur during the 65‐min study period.