Anesth Pain Med.
2010 Jan;5(1):82-86.
The optimal clinical dose of alfentanil for tracheal intubation during inhalation induction with sevoflurane after sedation with ketamine in children
- Affiliations
-
- 1Department of Anesthesiology, Yonsei University College of Medicine, Seoul, Korea.
- 2Department of Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Korea.
- 3Department of Anesthesiology, Gachon University of Medicine and Science, Gil Medical Center, Incheon, Korea. hyun615@gilhospital.com
Abstract
-
BACKGROUND: The purpose of this study was to determine the clinical effective dose of alfentanil required for successful tracheal intubation during inhalation induction using 5% sevoflurane without neuromuscular blockade in children sedated with ketamine.
METHODS
Twenty-one children, aged 3-10 years, undergoing surgeries under general anesthesia were enrolled into the study. All patients were premedicated with 0.004 mg/kg glycopyrrolate intramuscularly 30 min before anesthesia.To facilitate separation of the child from the parents, intravenous 1 mg/kg ketamine was given prior to transfer into the operating room.After inhalation induction with 5% sevoflurane and 100% oxygen, pre-determined dose of alfentanil was injected over 20 sec. The dose of alfentanil was determined by modified Dixon's up-and-down method (2microgramkg as a step size starting from 12microgramkg).The study ended when six independent pairs of patients, who manifested cross over from 'failure' to 'success' for tracheal intubation, were recruited.
RESULTS
In 50% of children, the effective bolus dose (ED50) (95% confidence intervals) of alfentanil for successful tracheal intubation was 7.2microgram/kg (6.3-8.1microgram/kg) during sevoflurane inhalation induction.From isotonic regression, 95% effective dose (ED95) (95% confidence intervals) of alfentanil was 9.9microgram/kg (2.2-16.0microgram/kg).
CONCLUSIONS
During inhalation induction using 5% sevoflurane without neuromuscular blockade after ketamine sedation, the ED50 and ED95 of alfentanil for successful tracheal intubation were 7.2 microgram/kg and 9.9microgram/kg in children, respectively.
Keyword
- Full Text Links
-
- Actions
-
Cited
- CITED
-
- Close
- Share
-
- Similar articles
-
- The clinical effective dose of rocuronium for lightwand tracheal intubation after induction with alfentanil, propofol, and low concentrations of sevoflurane
- The optimal effect site concentration of remifentanil for tracheal intubation without muscle relaxant during inhalation anesthetic induction using sevoflurane in adult
- The effect of remifentanil and lidocaine on time interval acquired for successful tracheal intubation in inhalational induction using sevoflurane
- Adequate sevoflurane concentrations in inhalation induction of sevoflurane following administration of remifentanil
- Effect of Low-dose Rocuronium on Tracheal Intubating Conditions during Induction of 8 vol% Sevoflurane with Remifentanil
