Document Detail

Predicted end-tidal sevoflurane concentration for insertion of a Laryngeal Mask Supreme: a prospective observational study.
MedLine Citation:
PMID:  23274620     Owner:  NLM     Status:  MEDLINE    
CONTEXT: The single-use Laryngeal Mask Airway (LMA) Supreme is a new supraglottic airway device. It has been reported to be reliable and easy-to-use in clinical practice; however, the anaesthetic techniques for its insertion are not standardised.
OBJECTIVES: The purpose of this study was to determine the ED50 of end-tidal sevoflurane concentration for successful LMA Supreme insertion without the use of neuromuscular blockade.
DESIGN: A prospective observational study.
SETTING: A single tertiary care surgical centre.
PATIENTS: Thirty-one consecutive elective patients scheduled for minor elective surgery under general anaesthesia.
INTERVENTION: Patients were preoxygenated with 100% oxygen and anaesthetised using normal tidal volume inhalation of sevoflurane. The target sevoflurane concentration was determined using a modified Dixon's 'up-and-down' method (starting at 2.5% with 0.5% as the step size). After the predetermined end-tidal concentration had been established and maintained for 10 min, LMA Supreme insertion was attempted.
MAIN OUTCOME MEASURE: The main outcome measure was the patient's response to LMA Supreme insertion, classified as either 'movement' or 'no movement'. The mean of the concentrations of seven cross-overs from 'movement' to 'no movement' was used to estimate the ED50.
RESULTS: The estimated sevoflurane concentration for successful LMA Supreme insertion in 50% of adults was 3.03 ± 0.75% (95% confidence interval 2.3 to 3.7%). The values of the ET50 and ET95 obtained by logistic regression were 2.83 and 5.30%, respectively.
CONCLUSION: Sevoflurane alone can provide acceptable conditions for insertion of the LMA Supreme in adults, at an estimated minimum alveolar anaesthetic concentration of 3% with minimal adverse effects.
Matilde Zaballos; Emilia Bastida; Consolación Jiménez; Salomé Agustí; M Teresa López-Gil
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  European journal of anaesthesiology     Volume:  30     ISSN:  1365-2346     ISO Abbreviation:  Eur J Anaesthesiol     Publication Date:  2013 Apr 
Date Detail:
Created Date:  2013-03-08     Completed Date:  2013-08-26     Revised Date:  2014-01-13    
Medline Journal Info:
Nlm Unique ID:  8411711     Medline TA:  Eur J Anaesthesiol     Country:  England    
Other Details:
Languages:  eng     Pagination:  170-4     Citation Subset:  IM    
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MeSH Terms
Anesthesia, General / methods*
Anesthetics, Inhalation / administration & dosage,  adverse effects,  pharmacokinetics*
Laryngeal Masks*
Logistic Models
Methyl Ethers / administration & dosage,  adverse effects,  pharmacokinetics*
Middle Aged
Oxygen / administration & dosage
Prospective Studies
Surgical Procedures, Elective / methods
Tidal Volume
Reg. No./Substance:
0/Anesthetics, Inhalation; 0/Methyl Ethers; 28523-86-6/sevoflurane; S88TT14065/Oxygen
Comment In:
Eur J Anaesthesiol. 2014 Jan;31(1):54   [PMID:  23877025 ]
Eur J Anaesthesiol. 2014 Jan;31(1):54-5   [PMID:  23884405 ]

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

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