Document Detail

Desflurane requirements for laryngeal mask airway insertion during inhalation induction.
MedLine Citation:
PMID:  19444559     Owner:  NLM     Status:  MEDLINE    
PURPOSE: We hypothesized that the simultaneous use of low concentrations (<6%) of desflurane, nitrous oxide (N(2)O), and fentanyl would allow a laryngeal mask airway (LMA) to be inserted safely with inhalation induction of desflurane, even in nonparalyzed patients. This prospective, observational study was performed to determine the 50% effective concentration (EC(50)) of desflurane for LMA insertion in such patients. METHODS: Twenty-two adult patients undergoing ambulatory surgical procedures under general anesthesia using an LMA were included in the study. Fentanyl was administered intravenously at 1.5 microg x kg(-1), and anesthesia was induced with desflurane in 50% N(2)O and oxygen, using a normal tidal volume breathing technique. Subsequently, a preselected steady-state end-tidal desflurane concentration was maintained for 10 min before insertion of the LMA. Successful LMA insertion was defined as the absence of adverse airway responses until cuff inflation. Target concentrations of desflurane for LMA insertion were determined using a modified Dixon's up-and-down method (starting dose, 5%; step size, 0.5%). RESULTS: All 22 patients completed the study without adverse events related to airway irritation. The EC(50) of desflurane for insertion of the LMA was determined to be 3.61 +/- 0.31%, and the 95% confidence interval (CI) of the EC(50) obtained using probit analysis was 3.13-3.90. CONCLUSION: We demonstrated that N(2)O-desflurane inhalation induction with a normal tidal breathing technique after premedication with fentanyl can be used safely without any adverse airway events in nonparalyzed patients. In such patients, the EC(50) of desflurane for successful LMA insertion was 3.61 +/- 0.31% (95% CI, 3.13-3.90).
Hwa-Yong Shin; Jung-Ae Lim; Seong-Hyop Kim; Seung-Woo Baek; Duk-Kyung Kim
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Publication Detail:
Type:  Journal Article     Date:  2009-05-15
Journal Detail:
Title:  Journal of anesthesia     Volume:  23     ISSN:  1438-8359     ISO Abbreviation:  J Anesth     Publication Date:  2009  
Date Detail:
Created Date:  2009-05-15     Completed Date:  2009-12-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8905667     Medline TA:  J Anesth     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  209-14     Citation Subset:  IM    
Department of Anesthesiology and Pain Medicine, Konkuk University School of Medicine, 1 Hwayang-Dong, Gwanggin-Gu, Seoul, 143-701, Korea.
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MeSH Terms
Adjuvants, Anesthesia
Anesthesia, Inhalation*
Anesthetics, Inhalation* / administration & dosage,  pharmacokinetics
Dose-Response Relationship, Drug
Hemodynamics / drug effects
Isoflurane / administration & dosage,  analogs & derivatives*,  pharmacokinetics
Laryngeal Masks*
Middle Aged
Nitrous Oxide
Prospective Studies
Young Adult
Reg. No./Substance:
0/Adjuvants, Anesthesia; 0/Anesthetics, Inhalation; 10024-97-2/Nitrous Oxide; 26675-46-7/Isoflurane; 437-38-7/Fentanyl; 57041-67-5/desflurane

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