What is it about?
Sevoflurane with Halothane for Endotracheal Intubation in Paediatric Patients
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Why is it important?
In paediatric patients, smooth induction with rapid endotracheal intubation without morbidity and mortality is of prime importance. Many of the inhalational anaesthetic agents have been tried for this purpose. In the present study, Sevoflurane due to its high potency, rapid induction, excellent intubating conditions with haemodynamic stability was compared with Halothane in paediatric patients. In the present study, 60 paediatric patients of ASA grade I and II of either sex were divided into 2 equal groups of 30 each according to inhalational anaesthetic agent used for induction of anaesthesia. In group S Sevoflurane 8% and group H Halothane 3% were used for induction of anaesthesia with Nitrous oxide/oxygen mixture on Boyles’ machine. All patients received Inj. Glycopyrolate 58µgm /kg and inj. Midazolam 0.25 µgm /kg as premedication 10 minutes prior to induction of anaesthesia. It was observed that, mean induction time in group S was 210±17 secs and in Group H 262±21 secs. Sevoflurane has low blood/gas coefficient of 0.69 as compared to Halothane 2.5, so quicker induction time with Sevoflurane as compared to Halothane. In group S, 90% of patients had excellent intubating conditions, 7% good and 3% had fair while in group H 84% had excellent intubating conditions, 13% had good and 3% had fair intubating conditions. During intubation, mean pulse rate decreased significantly in both groups and increased after intubation. The decrease in pulse rate was comparatively less in group S than group H and also there was significant increase in pulse rate after intubation in both groups. Similar changes were observed with mean systolic blood pressure and mean arterial pressure in both groups. Thus Sevoflurane provided better cardiovascular stability during and after intubation as compared to Halothane. We conclude that, Sevoflurane due to its cardiovascular stability, smooth induction, and excellent intubating conditions may be preferred over Halothane in paediatric patients for endotracheal intubation.
Perspectives
In paediatric patients, smooth induction with rapid endotracheal intubation without morbidity and mortality is of prime importance. Many of the inhalational anaesthetic agents have been tried for this purpose. In the present study, Sevoflurane due to its high potency, rapid induction, excellent intubating conditions with haemodynamic stability was compared with Halothane in paediatric patients. In the present study, 60 paediatric patients of ASA grade I and II of either sex were divided into 2 equal groups of 30 each according to inhalational anaesthetic agent used for induction of anaesthesia. In group S Sevoflurane 8% and group H Halothane 3% were used for induction of anaesthesia with Nitrous oxide/oxygen mixture on Boyles’ machine. All patients received Inj. Glycopyrolate 58µgm /kg and inj. Midazolam 0.25 µgm /kg as premedication 10 minutes prior to induction of anaesthesia. It was observed that, mean induction time in group S was 210±17 secs and in Group H 262±21 secs. Sevoflurane has low blood/gas coefficient of 0.69 as compared to Halothane 2.5, so quicker induction time with Sevoflurane as compared to Halothane. In group S, 90% of patients had excellent intubating conditions, 7% good and 3% had fair while in group H 84% had excellent intubating conditions, 13% had good and 3% had fair intubating conditions. During intubation, mean pulse rate decreased significantly in both groups and increased after intubation. The decrease in pulse rate was comparatively less in group S than group H and also there was significant increase in pulse rate after intubation in both groups. Similar changes were observed with mean systolic blood pressure and mean arterial pressure in both groups. Thus Sevoflurane provided better cardiovascular stability during and after intubation as compared to Halothane. We conclude that, Sevoflurane due to its cardiovascular stability, smooth induction, and excellent intubating conditions may be preferred over Halothane in paediatric patients for endotracheal intubation.
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This page is a summary of: Sevoflurane with Halothane for Endotracheal Intubation in Paediatric Patients: A Comparative Evaluation, Indian Journal of Anaesthesia and Analgesia, January 2018, Red Flower Publication Private, Ltd.,
DOI: 10.21088/ijaa.2349.8471.51018.19.
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