Information de reference pour ce titreAccession Number: | 00000539-200002000-00012.
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Author: | Allison, Celia E. MD *; De Lange, Jacob J. MD, PhD *; Koole, Frank D. MD +; Zuurmond, Wouter W. A. MD, PhD *; Ros, Herman H. PhD *; van Schagen, Nico T. BSc *
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Institution: | Departments of *Anesthesiology and +Ophthalmology, Academic Hospital Vrije Universiteit, Amsterdam, The Netherlands
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Title: | |
Source: | Anesthesia & Analgesia. 90(2):306-310, February 2000.
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Abstract: | We examined changes in the cardiorespiratory system of small children during surgical correction of strabismus with a laryngeal mask airway and spontaneous respiration with sevoflurane or halothane inhaled anesthesia. Fifty-one children, 1-7 yr old, having outpatient strabismus correction were randomized to sevoflurane (S) or halothane (H) in 66% nitrous oxide at 1.3 minimum alveolar concentration. Children breathed spontaneously through a laryngeal mask airway and were not pretreated with anticholinergics. The oculocardiac reflex (OCR), defined as a 20% decrease in heart rate (HR) from baseline, dysrhythmias, or sinoatrial arrest concomitant with ocular muscle traction occurred less frequently with sevoflurane than with halothane (S 38%, H79%, P = 0.009). The baseline HR was higher with sevoflurane (S 114 +/- 13 bpm, H 101 +/- 15 bpm, P = 0.002). The lowest HR occurred with halothane (S 95 +/- 22 bpm, H 73 +/- 19 bpm, P = 0.001). The incidence of dysrhythmias was higher in the halothane group (S 4%, H 42%, P = 0.004). Reductions in minute ventilation and PETCO2 accompanied OCRs. Airway irritability was present with halothane only (S 0, H 3). Eleven children, of whom the majority had received halothane, required measures to correct SpO2 < 95% or PETCO2 > 60 mm Hg during maintenance anesthesia (S 11%, H 32%). Sevoflurane may be a more suitable anesthetic than halothane for operations involving traction on the ocular muscles with spontaneous respiration in children because of reduced incidence of OCR, airway irritability, and ventilatory disturbances.
Implications: Some children experience a sudden slowing of the heart and impaired breathing when the surgeon pulls on the eye muscles during squint operations under anesthesia. Sevoflurane, a recently developed anesthetic vapor, may reduce this problem when compared with the established vapor halothane.
(C) 2000 International Anesthesia Research Society
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Language: | English.
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Document Type: | PEDIATRIC ANESTHESIA.
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Journal Subset: | Nursing. Clinical Medicine.
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ISSN: | 0003-2999
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NLM Journal Code: | 4r8, 1310650
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DOI Number: | https://dx.doi.org/10.1213/00000...- ouverture dans une nouvelle fenêtre
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