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Titolo:
RECOVERY CHARACTERISTICS OF DESFLURANE VERSUS HALOTHANE FOR MAINTENANCE OF ANESTHESIA IN PEDIATRIC AMBULATORY PATIENTS
Autore:
DAVIS PJ; COHEN IT; MCGOWAN FX; LATTA K;
Indirizzi:
CHILDRENS HOSP PITTSBURGH,DEPT ANESTHESIOL,3705 5TH AVE & DESOTO ST PITTSBURGH PA 15213 UNIV PITTSBURGH,SCH MED,DEPT ANESTHESIOL & CRIT CARE MED PITTSBURGH PA 15261
Titolo Testata:
Anesthesiology
fascicolo: 2, volume: 80, anno: 1994,
pagine: 298 - 302
SICI:
0003-3022(1994)80:2<298:RCODVH>2.0.ZU;2-F
Fonte:
ISI
Lingua:
ENG
Soggetto:
MINIMUM ALVEOLAR CONCENTRATION; NITROUS-OXIDE; CARDIOVASCULAR ACTIONS; SURGICAL PATIENTS; ISOFLURANE; CHILDREN; INFANTS; HUMANS; RESPONSES; INDUCTION;
Keywords:
ANESTHESIA, PEDIATRICS; ANESTHESIA TECHNIQUES, INHALATION; ANESTHETICS, VOLATILE, DESFLURANE, HALOTHANE;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
19
Recensione:
Indirizzi per estratti:
Citazione:
P.J. Davis et al., "RECOVERY CHARACTERISTICS OF DESFLURANE VERSUS HALOTHANE FOR MAINTENANCE OF ANESTHESIA IN PEDIATRIC AMBULATORY PATIENTS", Anesthesiology, 80(2), 1994, pp. 298-302

Abstract

Background: Desflurane is a new potent, inhaled anesthetic agent withlow blood-gas solubility that should allow for the rapid induction ofand emergence from anesthesia. However, its extreme pungency makes desflurane unacceptable for induction of anesthesia in children. This study was undertaken to determine the airway properties of desflurane administered by mask after anesthetic induction with halothane and nitrous oxide, and to compare the emergence and recovery properties of minimum alveolar concentration (MAC)-equivalent concentrations of desflurane or halothane in nitrous oxide in pediatric patients undergoing ambulatory surgery. Methods: Forty-five children undergoing ambulatory surgery for inguinal hernia repair, orchiopexy, and/or circumcision were randomized into two groups. Both groups were premedicated with intranasal midazolam and given halothane and nitrous oxide by mask to induce anesthesia. A caudal block was placed in children in both groups afteranesthetic induction. For maintenance of anesthesia, group I patients(n = 22) were switched over to desflurane (1 MAC) and nitrous oxide, and group II patients (n = 23) continued to receive halothane (1 MAC) and nitrous oxide. All patients breathed spontaneously throughout the entire procedure, and all anesthetics were terminated abruptly at the conclusion of surgery. Recovery indicators (time to first response, length of time in the recovery room and length of time in the hospital) and the quality of the anesthetic emergence were assessed by a nurse blinded to each patient's anesthetic This observer was present with thepatient throughout his or her ambulatory hospitalization and continuously assessed the recovery indicators according to preset criteria. Results: The groups did not differ with respect to age, weight or dose of midazolam. Although group I (desflurane) had a longer anesthesia time (52 +/- 12 min vs. 42 +/- 10 min), their time to first response (9.5+/- 6.8 min vs. 20.9 +/- 14.7 min) and their recovery room time (21 +/- 10.7 min vs. 29 +/- 14.6 min) were less than those in group II (halothane). There was a trend for patient emergence from desflurane anesthesia to be associated with a higher incidence of emergence delirium (50% vs. 21%). The two groups were similar with respect to overall duration of postoperative ambulatory hospitalization. Conclusions: In children premedicated with intranasal midazolam, desflurane maintenance anesthesia allows for a faster recovery. However, depending on the institution's criteria for ambulatory surgical patient discharge, desflurane may or may not affect the overall hospitalization time.

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Documento generato il 11/07/20 alle ore 15:16:29