Document Detail

A comparison of the respiratory effects of sevoflurane and halothane in infants and young children.
MedLine Citation:
PMID:  9667298     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: This study compared the respiratory effects of sevoflurane with those of halothane in anesthetized infants and young children. METHODS: Infants were randomized to receive 1 minimum alveolar concentration (MAC) halothane or sevoflurane in a mixture of nitrous oxide and oxygen. Anesthetic management included the use of a laryngeal mask. Flow, airway pressure, and the end-tidal carbon dioxide pressure (PETCO2) were measured during spontaneous ventilation and airway occlusions. Respiratory inductive plethysmography was used to assess chest wall motion. RESULTS: Measurements were obtained in 30 infants and young children (mean (SD) age, 14.5 (5.9) months), 15 of whom received sevoflurane and 15 received halothane. Some respiratory depression, as indicated by a PETCO2 of 45 mmHg (6 kPa), was present in both groups. Minute ventilation and respiratory frequency were significantly lower during sevoflurane than halothane anesthesia (4.5 compared with 5.4 (1/ m2)/min, and 37.5 compared with 46.7 breaths/min, respectively, P < 0.05). There was no difference in respiratory drive, but the shape of the flow waveform differed according to anesthetic agent, with peak inspiratory flow reached later, and peak expiratory flow reached earlier, in the sevoflurane group. There was also significantly less thoracoabdominal asynchrony during sevoflurane anesthesia. CONCLUSIONS: Minute ventilation and respiratory frequency were lower in infants during 1 MAC sevoflurane in nitrous oxide than during halothane anesthesia. However, these differences may not be clinically relevant at these concentrations, given the modest increase in PETCO2. Differences in parameters of breath timing and shape between sevoflurane and halothane suggest different effects of these anesthetic agents on ventilatory control.
K Brown; C Aun; J Stocks; E Jackson; A Mackersie; D Hatch
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Anesthesiology     Volume:  89     ISSN:  0003-3022     ISO Abbreviation:  Anesthesiology     Publication Date:  1998 Jul 
Date Detail:
Created Date:  1998-08-05     Completed Date:  1998-08-05     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  1300217     Medline TA:  Anesthesiology     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  86-92     Citation Subset:  AIM; IM    
Portex Anaesthesia, Intensive Therapy and Respiratory Medicine Unit, Institute of Child Health, London, United Kingdom.
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MeSH Terms
Anesthetics, Inhalation / administration & dosage*,  adverse effects*
Child, Preschool
Extremities / surgery*
Halothane / administration & dosage*,  adverse effects*
Infant, Newborn
Methyl Ethers / administration & dosage*,  adverse effects*
Pain / prevention & control*
Respiratory Physiological Phenomena*
Respiratory System / drug effects*
Reg. No./Substance:
0/Anesthetics, Inhalation; 0/Methyl Ethers; 151-67-7/Halothane; 28523-86-6/sevoflurane

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

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