Document Detail

Influence of nitrous oxide on minimum alveolar concentration of sevoflurane for laryngeal mask insertion in children.
MedLine Citation:
PMID:  14576538     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Inhalational induction with sevoflurane and nitrous oxide is frequently used for Laryngeal Mask Airway (LMA; Laryngeal Mask Company, Henley-on-Thames, United Kingdom) insertion in children. The authors determined the influence of nitrous oxide on the minimum alveolar concentration (MAC) of sevoflurane for LMA insertion. METHODS: One hundred twenty unpremedicated children (age, 1-9 yr; American Society of Anesthesiologists physical status I) were randomly assigned to receive 1 of 15 end-tidal concentrations of nitrous oxide and sevoflurane for inhalational induction via a facemask: 0% nitrous oxide with 1.2, 1.4, 1.6, 1.8, or 2.0% sevoflurane; 33% nitrous oxide with 0.8, 1.0, 1.2, 1.4, or 1.6% sevoflurane; or 67% nitrous oxide with 0.4, 0.6, 0.8, 1.0, or 1.2% sevoflurane. The LMA was inserted after steady state end-tidal anesthetic concentrations had been maintained for 15 min. The response to insertion was recorded by three independent blinded observers. The interaction between nitrous oxide and sevoflurane was determined using logistic regression analysis. RESULTS: The MAC of sevoflurane for LMA insertion (95% confidence limit) was 1.57% (1.42-1.72%), and the concentration of sevoflurane required to prevent movement in 95% of children was 1.99% (1.81-2.57%). The addition of 33% and 67% nitrous oxide linearly decreased the MAC of sevoflurane for LMA insertion by 22% and 49%, respectively (P < 0.001). The interaction coefficient between nitrous oxide and sevoflurane did not differ from zero (P = 0.7843), indicating that the relation was additive. CONCLUSIONS: Nitrous oxide and sevoflurane suppress the responses to LMA insertion in a linear and additive fashion in children.
Shinichi Kihara; Yuichi Yaguchi; Shinichi Inomata; Seiji Watanabe; Joseph R Brimacombe; Noriko Taguchi; Tetsuya Komatsuzaki
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Anesthesiology     Volume:  99     ISSN:  0003-3022     ISO Abbreviation:  Anesthesiology     Publication Date:  2003 Nov 
Date Detail:
Created Date:  2003-10-24     Completed Date:  2003-11-20     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  1300217     Medline TA:  Anesthesiology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1055-8     Citation Subset:  AIM; IM    
Department of Anesthesia, Mito Saiseikai General Hospital.
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MeSH Terms
Anesthetics, Inhalation* / administration & dosage,  pharmacokinetics
Child, Preschool
Dose-Response Relationship, Drug
Laryngeal Masks*
Logistic Models
Methyl Ethers* / administration & dosage
Monitoring, Intraoperative
Movement / drug effects
Nitrous Oxide* / administration & dosage,  pharmacokinetics
Pulmonary Alveoli / metabolism*
Single-Blind Method
Reg. No./Substance:
0/Anesthetics, Inhalation; 0/Methyl Ethers; 10024-97-2/Nitrous Oxide; 28523-86-6/sevoflurane
Comment In:
Anesthesiology. 2004 Sep;101(3):801; author reply 801   [PMID:  15329613 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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