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Minimum Alveolar Concentration of Sevoflurane for Laryngeal Mask Airway Removal in Children; the Effect of Caudal Anesthesia

Year 2009, Volume: 16 Issue: 1, 1 - 5, 01.02.2009

Zekine Begeç Mahmut Durmuş Feray Erdil Erdoğan Öztürk Aytaç Yücel M. Özcan Ersoy

Abstract

Objective: There has been no study evaluating sevoflurane minimum alveolar concentration for the laryngeal mask airway (LMA) removal (MAC-LMA removal) in children whom caudal anesthesia was performed. The aim of this study is to determine the MAC-LMA removal of sevoflurane in children caudal anesthesia was performed. Materials and Methods: Fifty-six children undergoing elective urologic surgery for <2 h under general anesthesia were studied. After sevoflurane induction, children were randomized to receive LMA insertion with or without caudal anesthesia. The LMA was removed at the end of surgery when the end-tidal sevoflurane concentration had reduced to a predetermined level with 0.2% as a step size by an anesthesiologist blinded to group allocation. When LMA removal was accomplished without coughing, teeth clenching, gross purposeful movement, breath holding or laryngospasm, during or within 1 min after removal, it was considered successful. Results: The MAC-LMA removal of sevoflurane was 1.60% in the group with caudal anesthesia and 1.72% in the group without caudal anesthesia. Conclusion: Caudal anesthesia did not reduce the MAC-LMA removal of sevoflurane in children aged 2 mo and 8 yr. Further studies are necessary to establish whether caudal block effect the removal of LMA in infant and children during sevoflurane anesthesia. Key words: Sevoflurane, Laryngeal Mask Airway, Caudal Anesthesia

Keywords

Sevoflurane Laryngeal Mask Airway Caudal Anesthesia

References

  • Mason DG, Bingham RM. The laryngeal airway in children. Anaesthesia 1990;45:760-3.
  • Almenrader N, Passariello M, D’amico G, Haiberger R, Pietropaoli P. Caudal additives for postoperative pain management in children: S(+)- ketamine and neostigmine. Paediatr Anaesth 2005;15:143-7.
  • Kitching AJ, Walpole AR, Blogg CE. Removal of the laryngeal mask airway in children: anaesthesized compared with awake. Br J Anaesth 1996;76:874-6.
  • Laffon M, Plaud B, Dubousset AM, Ben Haj’mida R, Ecoffey C. Removal of laryngeal mask airway: airway complications in children, anesthetized versus awake. Paediatr Anaesth 1994;4:35-7.
  • Patel Ri, Hannallah RS, Norden J, Casey WF, Verghese ST. Emergence airway complications in children: a comparison of tracheal extubation in awake and deeply anesthesized patients. Anesth Analg 1991;73:266-70.
  • Pappas AL, Sukhani R, Lurie J, Pawlowski J, Sawicki K, Corsino A. Severity of airway hyperreactivity associated with laryngeal mask airway removal: correlation with volatile anesthetic choice and depth of anesthesia. J Clin Anesth 2001;13:498-503.
  • Ben-David B, Vaida S, Gaitini L. The influence of high spinal anesthesia on sensitivity to midazolam sedation. Anesth Analg 1995;81:525-8.
  • Hodgson PS, Liu SS. Epidural lidocaine decreases sevoflurane requirement for adequate depth of anesthesia as measured by the bispectral index® monitor. Anesthesiology 2001;94:799- 803.
  • Xiao WJ, Deng XM, Tang GZ, Lu MP, Xu KL. Caudal anesthesia reduces the minimum alveolar concentration of enflurane for laryngeal mask airway removal in boys. Can J Anesth 2002;49:194-7.
  • Dixon WJ. Staircase bioassay: the up-and-down method. Neurosci Biobehav Rev 1991;15:47-50
  • Lee JR, Kim SD, Kim CS, Yoon TG, Kim HS. Minimum alveolar concentration of sevoflurane for laryngeal mask airway removal in anesthetized children. Anesth Analg 2007;104:528- 31.
  • Nunez J, Hughes J, Wareham K, Asai T. Timing of removal of the laryngeal mask airway. Anaesthesia 1998;53:126-30.
  • Cameron AJ, Sellers WF. Early vs late LMA removal: risks to patients and damage to equipment. Anaesth Intens Care 2001;29:80-1.
  • O’Neil B, Templeton JJ, Caramico L, Schreiner MS. The laryngeal mask airway in pediatric patients: factors affecting ease of use during insertion and emergence. Anesth Analg 1994;78:659-62.
  • Gataura PS, Latto IP, Rust S. Complications associated with removal of the laryngeal mask airway: a comparison of removal in deeply anaesthetised versus awake patients. Can J Anaesth 1995;42:1113-6.
  • Splinter WM, Reid CW. Removal of the laryngeal mask airway in children: Deep anesthesia versus awake. J Clin Anesth 1997;9:4-7.
  • Seyhan TO, Sungur MO, Sentürk E, Karadeniz M, Basel A, Sentürk M, Akpir K. BIS guided sedation with propofol during spinal anaesthesia: influence of anaesthetic level on sedation requirement. Br J Anaesth 2006;5:645-9.
  • Sites BD, Blike G, Cravero J, Andeweg S, Beach M. Single- dose caudal anaesthesia for two infants undergoing brain magnetic resonance imaging: high risk and non high risk. Paediatr Anaesth 2003;13:171-4.
  • Eappen S, Kissin I. Effect of subarachnoid bupivacaine block on anesthetic requirements for thiopental in rats. Anesthesiology 1998;88:1036-42.
  • Davidson AJ, Ironfield CM, Skinner AV, Frawley GP. The effects of caudal local anesthesia blockade on the Bispectral index during general anesthesia in children. Paediatr Anaesth 2006;16:828-33.
  • Corresponding Author: Zekine BEGEÇ, MD.
  • Inonu University, School of Medicine,
  • MALATYA-TURKEY
  • Phone: +905334672937 Fax: +904223410036
  • E-mail: zozpolat@inonu.edu.tr

Çocuklarda Laringeal Maskenin Çıkarılması İçin Gerekli Sevofluran Minimum Alveoler Konsantrasyonuna Kaudal Anestezinin Etkisi

Year 2009, Volume: 16 Issue: 1, 1 - 5, 01.02.2009

Zekine Begeç Mahmut Durmuş Feray Erdil Erdoğan Öztürk Aytaç Yücel M. Özcan Ersoy

Abstract

Amaç: Kaudal anestezi uygulanan çocuklarda laringeal maske (LMA) çıkarılması için gerekli sevofluran minimum alveolar konsantrasyonunu (MAK) değerlendiren bir çalışma bulunmamaktadır. Çalışmanın amacı kaudal anestezi uygulanmış çocuklarda LMA çıkarılması için gerekli sevofluran MAK'ını belirlemektir. Materyal ve Metod: Genel anestezi ile ürolojik cerrahiye giden (<2 saat) 56 çocuk çalışmaya alındı. Sevofluran indüksiyonundan sonra LMA yerleştirilen çocuklar kaudal anestezi yapılan ve yapılmayan grup olarak ayrıldı. Cerrahi işlemin sonunda LMA; grupları bilmeyen bir anestezist tarafından, end-tidal sevofluran konsantrasyonu önceden belirlenen % 0.2'lik konsantrasyonlarla azaltılarak çıkartıldı. LMA çıkarılması sırasında veya çıkarıldıktan sonra 1 dakika içinde, öksürük, diş sıkma, amaçlı hareket, nefes tutma veya laringospazm eşlik etmiyorsa LMA çıkarılması başarılı olarak kabul edildi. Bulgular: Çocuklarda LMA çıkarılması için gerekli sevofluran MAK'ı kaudal anestezi uygulanan grupta %1.60, kaudal anestezi uygulanmayan grupta %1.72 idi. Sonuç: İki ay-8 yaş arası çocuklarda kaudal anestezi; LMA çıkarılması için gerekli sevofluran MAK'ını azaltmadı. Kaudal bloğun infant ve çocuklarda LMA çıkarılması için gerekli sevofluran MAK'ına etkisini araştıran ileri çalışmalara ihtiyaç olduğu kanaatine varıldı. Anahtar kelimeler: Sevofluran, Laringeal Maske, Kaudal Anestezi

Keywords

Sevofluran Laringeal Maske Kaudal Anestezi

References

  • Mason DG, Bingham RM. The laryngeal airway in children. Anaesthesia 1990;45:760-3.
  • Almenrader N, Passariello M, D’amico G, Haiberger R, Pietropaoli P. Caudal additives for postoperative pain management in children: S(+)- ketamine and neostigmine. Paediatr Anaesth 2005;15:143-7.
  • Kitching AJ, Walpole AR, Blogg CE. Removal of the laryngeal mask airway in children: anaesthesized compared with awake. Br J Anaesth 1996;76:874-6.
  • Laffon M, Plaud B, Dubousset AM, Ben Haj’mida R, Ecoffey C. Removal of laryngeal mask airway: airway complications in children, anesthetized versus awake. Paediatr Anaesth 1994;4:35-7.
  • Patel Ri, Hannallah RS, Norden J, Casey WF, Verghese ST. Emergence airway complications in children: a comparison of tracheal extubation in awake and deeply anesthesized patients. Anesth Analg 1991;73:266-70.
  • Pappas AL, Sukhani R, Lurie J, Pawlowski J, Sawicki K, Corsino A. Severity of airway hyperreactivity associated with laryngeal mask airway removal: correlation with volatile anesthetic choice and depth of anesthesia. J Clin Anesth 2001;13:498-503.
  • Ben-David B, Vaida S, Gaitini L. The influence of high spinal anesthesia on sensitivity to midazolam sedation. Anesth Analg 1995;81:525-8.
  • Hodgson PS, Liu SS. Epidural lidocaine decreases sevoflurane requirement for adequate depth of anesthesia as measured by the bispectral index® monitor. Anesthesiology 2001;94:799- 803.
  • Xiao WJ, Deng XM, Tang GZ, Lu MP, Xu KL. Caudal anesthesia reduces the minimum alveolar concentration of enflurane for laryngeal mask airway removal in boys. Can J Anesth 2002;49:194-7.
  • Dixon WJ. Staircase bioassay: the up-and-down method. Neurosci Biobehav Rev 1991;15:47-50
  • Lee JR, Kim SD, Kim CS, Yoon TG, Kim HS. Minimum alveolar concentration of sevoflurane for laryngeal mask airway removal in anesthetized children. Anesth Analg 2007;104:528- 31.
  • Nunez J, Hughes J, Wareham K, Asai T. Timing of removal of the laryngeal mask airway. Anaesthesia 1998;53:126-30.
  • Cameron AJ, Sellers WF. Early vs late LMA removal: risks to patients and damage to equipment. Anaesth Intens Care 2001;29:80-1.
  • O’Neil B, Templeton JJ, Caramico L, Schreiner MS. The laryngeal mask airway in pediatric patients: factors affecting ease of use during insertion and emergence. Anesth Analg 1994;78:659-62.
  • Gataura PS, Latto IP, Rust S. Complications associated with removal of the laryngeal mask airway: a comparison of removal in deeply anaesthetised versus awake patients. Can J Anaesth 1995;42:1113-6.
  • Splinter WM, Reid CW. Removal of the laryngeal mask airway in children: Deep anesthesia versus awake. J Clin Anesth 1997;9:4-7.
  • Seyhan TO, Sungur MO, Sentürk E, Karadeniz M, Basel A, Sentürk M, Akpir K. BIS guided sedation with propofol during spinal anaesthesia: influence of anaesthetic level on sedation requirement. Br J Anaesth 2006;5:645-9.
  • Sites BD, Blike G, Cravero J, Andeweg S, Beach M. Single- dose caudal anaesthesia for two infants undergoing brain magnetic resonance imaging: high risk and non high risk. Paediatr Anaesth 2003;13:171-4.
  • Eappen S, Kissin I. Effect of subarachnoid bupivacaine block on anesthetic requirements for thiopental in rats. Anesthesiology 1998;88:1036-42.
  • Davidson AJ, Ironfield CM, Skinner AV, Frawley GP. The effects of caudal local anesthesia blockade on the Bispectral index during general anesthesia in children. Paediatr Anaesth 2006;16:828-33.
  • Corresponding Author: Zekine BEGEÇ, MD.
  • Inonu University, School of Medicine,
  • MALATYA-TURKEY
  • Phone: +905334672937 Fax: +904223410036
  • E-mail: zozpolat@inonu.edu.tr
There are 25 citations in total.

Details

Primary Language Turkish
Journal Section Articles
Authors

Zekine Begeç This is me

Mahmut Durmuş This is me

Feray Erdil This is me

Erdoğan Öztürk This is me

Aytaç Yücel This is me

M. Özcan Ersoy This is me

Publication Date February 1, 2009
Published in Issue Year 2009 Volume: 16 Issue: 1

Cite

APA Begeç, Z., Durmuş, M., Erdil, F., Öztürk, E., et al. (2009). Çocuklarda Laringeal Maskenin Çıkarılması İçin Gerekli Sevofluran Minimum Alveoler Konsantrasyonuna Kaudal Anestezinin Etkisi. Journal of Turgut Ozal Medical Center, 16(1), 1-5.
AMA Begeç Z, Durmuş M, Erdil F, Öztürk E, Yücel A, Ersoy MÖ. Çocuklarda Laringeal Maskenin Çıkarılması İçin Gerekli Sevofluran Minimum Alveoler Konsantrasyonuna Kaudal Anestezinin Etkisi. J Turgut Ozal Med Cent. February 2009;16(1):1-5.
Chicago Begeç, Zekine, Mahmut Durmuş, Feray Erdil, Erdoğan Öztürk, Aytaç Yücel, and M. Özcan Ersoy. “Çocuklarda Laringeal Maskenin Çıkarılması İçin Gerekli Sevofluran Minimum Alveoler Konsantrasyonuna Kaudal Anestezinin Etkisi”. Journal of Turgut Ozal Medical Center 16, no. 1 (February 2009): 1-5.
EndNote Begeç Z, Durmuş M, Erdil F, Öztürk E, Yücel A, Ersoy MÖ (February 1, 2009) Çocuklarda Laringeal Maskenin Çıkarılması İçin Gerekli Sevofluran Minimum Alveoler Konsantrasyonuna Kaudal Anestezinin Etkisi. Journal of Turgut Ozal Medical Center 16 1 1–5.
IEEE Z. Begeç, M. Durmuş, F. Erdil, E. Öztürk, A. Yücel, and M. Ö. Ersoy, “Çocuklarda Laringeal Maskenin Çıkarılması İçin Gerekli Sevofluran Minimum Alveoler Konsantrasyonuna Kaudal Anestezinin Etkisi”, J Turgut Ozal Med Cent, vol. 16, no. 1, pp. 1–5, 2009.
ISNAD Begeç, Zekine et al. “Çocuklarda Laringeal Maskenin Çıkarılması İçin Gerekli Sevofluran Minimum Alveoler Konsantrasyonuna Kaudal Anestezinin Etkisi”. Journal of Turgut Ozal Medical Center 16/1 (February 2009), 1-5.
JAMA Begeç Z, Durmuş M, Erdil F, Öztürk E, Yücel A, Ersoy MÖ. Çocuklarda Laringeal Maskenin Çıkarılması İçin Gerekli Sevofluran Minimum Alveoler Konsantrasyonuna Kaudal Anestezinin Etkisi. J Turgut Ozal Med Cent. 2009;16:1–5.
MLA Begeç, Zekine et al. “Çocuklarda Laringeal Maskenin Çıkarılması İçin Gerekli Sevofluran Minimum Alveoler Konsantrasyonuna Kaudal Anestezinin Etkisi”. Journal of Turgut Ozal Medical Center, vol. 16, no. 1, 2009, pp. 1-5.
Vancouver Begeç Z, Durmuş M, Erdil F, Öztürk E, Yücel A, Ersoy MÖ. Çocuklarda Laringeal Maskenin Çıkarılması İçin Gerekli Sevofluran Minimum Alveoler Konsantrasyonuna Kaudal Anestezinin Etkisi. J Turgut Ozal Med Cent. 2009;16(1):1-5.