Intubation without Muscle Relaxant: The Role of Sevoflurane

Background: Sevoflurane is preferred for induction of general anesthesia in pediatrics. We examined the minimum duration of sevoflurane administration resulting in most optimal intubation conditions. Methods: We included 75 children, aged 2-12 years, undergoing tonsillectomy under general anesthesi...

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Main Authors: Fatemeh Hajimohamadi, Abolghasem Yoosefi, Mehrdad Behzadi, Nader Ali Nazemian Yazdi, Hamed Abdollahi, Afshar Etemadi-Aleagha, Samira Parvizi Omran
Format: Article
Language:English
Published: Tehran University of Medical Sciences 2022-10-01
Series:Archives of Anesthesia and Critical Care
Subjects:
Online Access:https://aacc.tums.ac.ir/index.php/aacc/article/view/509
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author Fatemeh Hajimohamadi
Abolghasem Yoosefi
Mehrdad Behzadi
Nader Ali Nazemian Yazdi
Hamed Abdollahi
Afshar Etemadi-Aleagha
Samira Parvizi Omran
author_facet Fatemeh Hajimohamadi
Abolghasem Yoosefi
Mehrdad Behzadi
Nader Ali Nazemian Yazdi
Hamed Abdollahi
Afshar Etemadi-Aleagha
Samira Parvizi Omran
author_sort Fatemeh Hajimohamadi
collection DOAJ
description Background: Sevoflurane is preferred for induction of general anesthesia in pediatrics. We examined the minimum duration of sevoflurane administration resulting in most optimal intubation conditions. Methods: We included 75 children, aged 2-12 years, undergoing tonsillectomy under general anesthesia at Amir-Alam Hospital. They were given midazolam 0.05 mg/kg and fentanyl 2 mic/kg IV, five minutes before induction with sevoflurane 8% in 60% N2O and 40% O2 with total gas flow of 10 lit/min via face mask for 90 seconds (group I), 120 sec (group II) or 150 sec (group III), randomly. After tracheal intubation, intubation condition was assessed using Steyn's modification of Helbo Hansen scoring system. The total scores were divided into clinically acceptable (≤10) or unacceptable (>10). Results: There was no statistically significant difference among the three groups in demographic characteristics. Mean ± SD of intubation scores were 10.04±2.9, 8.12±3.2, and 5.64±1.15 in groups 1-3, respectively (P<0.001) with statistically significant differences between all three groups: between groups I and II (P=0.044), I and III (P<0.001), as well as II and III (P=0.004). Intubation conditions were acceptable in 11, 16, and 25 patients in each group, respectively (P<0.001). Conclusion: Inhalation induction by sevoflurane 8% in 150s provides acceptable clinical situation for intubation in pediatrics.
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spelling doaj.art-2e4e140ef039431d965f696c8161e0e02023-02-20T08:41:08ZengTehran University of Medical SciencesArchives of Anesthesia and Critical Care2423-58492022-10-019110.18502/aacc.v9i1.11944Intubation without Muscle Relaxant: The Role of SevofluraneFatemeh Hajimohamadi0Abolghasem Yoosefi1Mehrdad Behzadi2Nader Ali Nazemian Yazdi3Hamed Abdollahi4Afshar Etemadi-Aleagha5Samira Parvizi Omran6Department of Anesthesiology, Amir A’lam Hospital, Tehran University of Medical Sciences, Tehran, Iran.Department of Anesthesiology, Amir A’lam Hospital, Tehran University of Medical Sciences, Tehran, Iran.Department of Anesthesiology, Amir A’lam Hospital, Tehran University of Medical Sciences, Tehran, Iran.Department of Anesthesiology, Amir A’lam Hospital, Tehran University of Medical Sciences, Tehran, Iran.Department of Anesthesiology, Amir A’lam Hospital, Tehran University of Medical Sciences, Tehran, Iran.Department of Anesthesiology, Amir A’lam Hospital, Tehran University of Medical Sciences, Tehran, Iran.Department of Anesthesiology, Amir A’lam Hospital, Tehran University of Medical Sciences, Tehran, Iran. Background: Sevoflurane is preferred for induction of general anesthesia in pediatrics. We examined the minimum duration of sevoflurane administration resulting in most optimal intubation conditions. Methods: We included 75 children, aged 2-12 years, undergoing tonsillectomy under general anesthesia at Amir-Alam Hospital. They were given midazolam 0.05 mg/kg and fentanyl 2 mic/kg IV, five minutes before induction with sevoflurane 8% in 60% N2O and 40% O2 with total gas flow of 10 lit/min via face mask for 90 seconds (group I), 120 sec (group II) or 150 sec (group III), randomly. After tracheal intubation, intubation condition was assessed using Steyn's modification of Helbo Hansen scoring system. The total scores were divided into clinically acceptable (≤10) or unacceptable (>10). Results: There was no statistically significant difference among the three groups in demographic characteristics. Mean ± SD of intubation scores were 10.04±2.9, 8.12±3.2, and 5.64±1.15 in groups 1-3, respectively (P<0.001) with statistically significant differences between all three groups: between groups I and II (P=0.044), I and III (P<0.001), as well as II and III (P=0.004). Intubation conditions were acceptable in 11, 16, and 25 patients in each group, respectively (P<0.001). Conclusion: Inhalation induction by sevoflurane 8% in 150s provides acceptable clinical situation for intubation in pediatrics. https://aacc.tums.ac.ir/index.php/aacc/article/view/509AnesthesiaInhalationSevofluraneTracheal intubation
spellingShingle Fatemeh Hajimohamadi
Abolghasem Yoosefi
Mehrdad Behzadi
Nader Ali Nazemian Yazdi
Hamed Abdollahi
Afshar Etemadi-Aleagha
Samira Parvizi Omran
Intubation without Muscle Relaxant: The Role of Sevoflurane
Archives of Anesthesia and Critical Care
Anesthesia
Inhalation
Sevoflurane
Tracheal intubation
title Intubation without Muscle Relaxant: The Role of Sevoflurane
title_full Intubation without Muscle Relaxant: The Role of Sevoflurane
title_fullStr Intubation without Muscle Relaxant: The Role of Sevoflurane
title_full_unstemmed Intubation without Muscle Relaxant: The Role of Sevoflurane
title_short Intubation without Muscle Relaxant: The Role of Sevoflurane
title_sort intubation without muscle relaxant the role of sevoflurane
topic Anesthesia
Inhalation
Sevoflurane
Tracheal intubation
url https://aacc.tums.ac.ir/index.php/aacc/article/view/509
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