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2003, Number 2

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Rev Mex Anest 2003; 26 (2)

Sevofluorano como único anestésico por mascarilla facial para el manejo de los pacientes pediátricos en la tomografía axial computada.

Blanco PMJ, Castro CHP, Pérez OMG, Canto BAA

Language: Spanish
References: 46
Page: 67-74
PDF size: 186.66 Kb.


ABSTRACT

Background: Anesthesia outside the operating room is a big challenge, due to the difficulties experienced when the working place is not designed for the anesthesiologist. To provide anesthesia to the children to maintain absolute immobility that the Computed Tomography Scan (CTS) requires is an industry standard at the present time. To apply a safe and useful anesthetic technique, with minimum invasion is an important goal. Material and methods: We studied 350 children, with ages ranging from newborn to 12 years old of both sexes, to whom sevoflurane was administered via facial mask, without instrumentation of the airway, as the sole anesthetic, for CTS. The anesthetic induction was achieved via inhalation bolus technique, and maintence using the least possible sevoflurane dose (surgical painful stimulus does not exist in this radiological procedure). The facial mask was held in place using an occipital rubber harness allowing spontaneous breathing. The patient’s safety was evaluated looking for the absence of complications and ventilatory depression (hipercapnia). The usefulness was evaluated considering the number of cases which showed undesirable movements or the need of anesthesiologist attendance. We also measured the minimum sevoflurane dose (in percentage of inspired volume) required for the maintenance, the latency of induction, and the time required for patient’s recovery and discharge. Results: None of the patients had complications neither ventilatory depression. It was not necessary to interrupt the CTS in any of the cases. Difussion: We consider that this method is reliable and safe for the anesthetic management of pediatric patients undergoing CTS.


REFERENCES

  1. Gillies BS, Lecky JH: Anestesia Fuera del Quirófano, en Barash PG, Cullen BF, Stoelting RK Anestesia Clínica, Tercera Edición, McGraw Hill Interamericana Editores SA de CV, México, DF, 1999, 1455-67.

  2. Hughes CW: Anestesia en Lugares Distantes, en Bell Ch, Hughes CW, Oh TH: Manual de Anestesia Pediátrica Departamento de Anestesiología Facultad de Medicina Universidad de Yale, Primera Edición, Editorial Mosby-Year Book, Madrid, España, 1993, 485-96.

  3. Coté Ch: Anestesia Fuera del Quirófano, en Coté Ch, Ryan JF, Todres ID, Goudsouzian NG: Anestesia en Pediatría, Segunda Edición, Nueva Editorial Interamericana SA de CV, México DF, 1995, 433-48.

  4. Messick JM, MacKenzie RA, Southorn PS: Anestesia fuera de las salas de cirugía, en Miller RD: Anestesia, Cuarta Edición, Harcourt Brace de España S.A., Madrid, España, 1998, 2189-217.

  5. Ballantyne JC, Cowan GA: Anestesia Fuera del Quirófano, en Huford WE, Baillin MT, Davison JK, Haspel KL, Rosow C: Massachussets General Hospital Procedimientos en Anestesia, Quinta Edición, Editorial Marbán Libros S.L., Madrid, España, 1999, 553-61.

  6. Hall S: Anestesia fuera del quirófano, en Twersky RS : Anestesia Ambulatoria, Harcourt Brace de España SA, Madrid, España, 1995, 383-421.

  7. Greemberg CP, De Soto H: Técnicas de Sedación, en Twersky RS: Anestesia Ambulatoria, Harcourt Brace de España S.A., Madrid, España, 1995, 319-82.

  8. Morgan GE, Mikhail MS: Anestésicos No volátiles, en: Anestesiología Clínica, Segunda Edición, Editorial Manual Moderno S.A. de C.V., México, DF, 1998, 151-74.

  9. Hemelrijck JV, White PF: Anestesia Intravenosa con Agentes No Opioides, en Barash PG, Cullen BF, Stoelting RK: Anestesia Clínica, Tercera Edición, McGraw Hill-Interamericana Editores SA de CV, México DF, 1999, 367-87.

  10. Frankville DD, Spear RM, Dyck JB: The Dose of Propofol Required to Prevent Children from Moving during Magnetic Resonance Imaging. Anesthesiology 1993; 79: 953-58.

  11. Viviand X: Propfol, en Encyclopédie Médico - Chirurgicale Anestesia Reanimación, Editions Techniques de México, México DF, 1999, páginas 36 -305 - A -10.

  12. Liu LMP, Ryan J: Premedicación e inducción de la anestesia, en Coté CH J, Ryan JF, Todres ID, Goudsouzian NG: Anestesia en Pediatría, Segunda Edición, Nueva Editorial Interamericana S.A. de C.V., México D.F., 1993, 141-156.

  13. Lerman JL: Sevoflurano en Anestesia Pediátrica. Anesth Analg 1995; 81: S4-10.

  14. Lerman JL, Sikich N, Kleinman S, Yentis S: The Pharmacology of Sevoflurane in Infants and Children. Anesthesiology 1994; 80: 814-24.

  15. Holzman RS, Van der Velde ME, Kaus SJ: Sevoflurane Depresses Myocardial Contractility Less Than Halothane during Induction of Anesthesia in Children. Anesthesiology 1996; 85: 1260-67.

  16. Rice LJ, Cravero J: Anestesia Pediátrica, en Barash PG, Cullen BF, Stoelting RK: Anestesia Clínica, Tercera Edición, Mc Graw Hill Interamericana Editores S.A. de C.V., México DF, 1999, 1309-20.

  17. Thwaites A, Edmends S, Smith I: Inhalation induction with sevoflurane: a double-bind comparison with propofol. Br J Anaesth 1997; 78 : 356-61.

  18. Peruzzi WT, Shapiro BA: Arterial Blood Gases, en Parrillo Jem, Dellinger RP: Critical Care Medicine. Pinciples of Diagnosis and Management in the Adult. Second Edition, Mosby A Harcourt Health Sciences Company.St. Louis Missouri, 2001, 202-23.

  19. Blázquez BM, Triadó VD: Criterios de Alta en Cirugía Ambulatoria, en Carrasco MS: Anestesia para Cirugía Ambulatoria II, Edika Med, Barcelona, España, 2000, 219-38.

  20. White PF: Anestesia en Cirugía Ambulatoria, en Torres LM: Tratado de Anestesia y Reanimación, Arán Ediciones S.A., Madrid España, 2001, 2107-15.

  21. Philip BK, Lombard LL, Roaf ER, Drager LR, Calalang I, Philip JH: Comparison of vital capacity induction with sevoflurane to intravenous induction with propofol for adult ambulatory anesthesia. Anesth Analg 1999; 89: 623-27

  22. Yurino M, Kimura H: Vital capacity breath technique for rapid anaesthetic induction: Comparison of sevoflurane and isoflurane. Anaesthesia, 1992; 47: 94-49.

  23. Yurino M, Kimura H: Induction of anesthesia with sevoflurane, nitrous oxide, and oxygen: A comparison of spontaneous ventilation and vital capacity rapid inhalation induction (VCRII) techniques. Anesth Analg 1993; 76: 598-601.

  24. Andrews JJ: Sistemas de Administración para Anestésicos Inhalables, en Barash PG, Cullen BF, Stoelting RK: Anestesia Clínica, Tercera Edición, McGraw Hill Interamericana Editores S.A. de C.V., México DF, 1999; 627-70.

  25. Inomata S, Suwa T, Toyooka H, Suto Y: End-Tidal sevoflurane concentration for tracheal extubation and skin incision in children. Anesth Analg 1998; 87: 1263-67.

  26. Morgan GE, Mikhail MS: Anestésicos por Inhalación, en: Anestesiología Clínica, Segunda Edición, Editorial Manual Moderno, México, DF, 1998, 129-50.

  27. Naito Y, Tamai S, Shingu K, Fujimori R, Mori K: Comparison between sevoflurane and halothane for paediatric ambulatory anaesthesia. Br J Anaesth 1991; 67: 387-89.

  28. Galdo JR, Palacio MA, Campuzano G : Anestesia fuera del quirófano, en Torres LM: Tratado de Anestesia y Reanimación, Arán Ediciones SA, Madrid España, 2001, 211 -36.

  29. Eger E II: New Inhaled Anesthetics. Anesthesiology 1994; 80: 906-22.

  30. Lerman J, Davis PJ, WelbornLG: Induction, recovery, and Safety Characteristics of Sevoflurane in Children Undergoing Ambulatory Surgery. Anesthesiology 1996: 84: 1332-40.

  31. Kaisti KK, Jaaskelainen SK, Rinne JO: Epileptiform Discharges during 2 MAC Sevoflurane Anesthesia in Two Healthy Volunteers. Anesthesiology, 1999; 91: 1952-55.

  32. Woodforth IJ, Hicks RG, Crawford MR, Stephen JP: Electroencephalographic evidence of seizure activity under deep sevoflurane anesthesia in a nonepileptic patient. Anesthesiology 1997; 87: 1579-82.

  33. Komatzu H, Taie S, Endo S, Fukuda K, Ueki M, Nogaya Jn: Electrical seizures during sevoflurane anesthesia in two pediatric patients with epilepsy. Anesthesiology 1994; 81: 1535-37.

  34. Adachi M, IkemotoY, Kubo K, Takuma C: Seizure like movements during induction of anaesthesia with sevoflurane. Br J Anaesth 1992; 68: 214-15.

  35. Davis PJ, Greemberg JA, Gendelman M, Fertal K: Recovery Characteristics of Sevoflurane and Halothane in Preschool-Aged Children Undergoing Bilateral Miringotomy and Pressure Equalization Tube Insertion. Anesth Analg 1999; 88: 34-8.

  36. Wells LT, Rasch DK: Emergence “Delirium” After Sevoflurane Anesthesia: A Paranoid Delusion? Anesth Analg 1999; 88: 1308-10.

  37. Aono J, Ueda W, Mamiya K: Greater incidence of delirium during recovery from sevoflurane anesthesia in preschool boys. Anesthesiology 1997; 8: 1298-300.

  38. Malan TP, DiNardo JA, Isner J: Cardiovascular Effects of Sevoflurane Compared with Those of Isoflurane in volunteers. Anesthesiology 1995; 83: 918-28.

  39. Sarner JB, Levine M, Davis PT: Clinical Characteristics of Sevoflurane in Children. Anesthesiology 1995; 82: 38-46.

  40. Ebert TJ, Harkin CP, Muzi M: Respuestas Cardiovasculares al sevoflurano. Una Revisión. Anesth Analg 1995; 81: S4-10.

  41. Morio M, Fujii K, Satoh N: Reaction of Sevoflurane and Its Degradation Products with Soda Lime. Anesthesiology 1992; 77: 1155-64.

  42. Miyano K, Nakasawa M, tanifuji Y: Reactivity of sevofluane with carbon dioxide absorbants: comparison of soda lime and Baralyme. Masui 1991; 40: 384-90.

  43. Higuchi,H, Sumita S, Wada H: Effects of Sevoflurane and Isoflurane on Renal Function and Possible Markers of Nephrotoxicity. Aneshesiology 1998; 89: 307-22.

  44. Eger EI II, Koblin DD, Bowland T, Ionescu P: Nephotocixity of sevoflurane versus desflurano anesthesia in volunteers. Anesth Analg 1997; 84: 160-8.

  45. Bito H, Ikeda K: Closed-circuit anesthesia with sevoflurane in humans: Effects on renal and hepatic function and concentrations of breakdown products with soda lime en the circuit. Anesthesiology 1994; 80: 71-6.

  46. Kharasch ED, Frink EJ Jr, Zager R: Assessment of low-flow sevoflurane and isoflurane effects on renal function using sensitive markers of tubular toxicity. Anesthesiology 1997; 86: 1238-53.




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