J Korean Burn Soc.  2010 Jun;13(1):16-20.

Volatile Induction and Maintenance of Anesthesia without Intravenous Access in Mild to Moderate Burn Injured Pediatric Patients

Affiliations
  • 1Department of Anesthesiology and Pain Medicine, Pureun Hospital Burn Center, Daegu, Korea. weonjo@pnuyh.co.kr
  • 2Department of Burn Surgery, Pureun Hospital Burn Center, Daegu, Korea.

Abstract

PURPOSE
Peripheral intravenous (I.V.) access is a common but stressful procedure in children, their parents and medical staffs. We evaluated the efficacy of volatile induction and maintenance of anesthesia (VIMA) without intravenous access for brief procedures in mild to moderate burn-injured pediatric patients.
METHODS
VIMA without I.V. was conducted to healthy pediatric patients. Adverse events such as cough, breath holding, airway obstruction, arrhythmia, bradycardia and tachycardia, etc. were evaluated.
RESULTS
From July 2008 to December 2009, 1,495 cases of VIMA with sevoflurane were performed in 859 children. Burn-injured patients were 94.9% and patients with hypertrophic scar were 5.1%. Scalding burn and contact burn were 90.1% of the burn-injured patients. Mean anesthesia duration was 29.3+/-6.2 min. In 1,495 VIMA cases, 47 cases had cardiovascular adverse events, including tachycardia (36), bradycardia (7), arrhythmia (3), and hypertension (1). All of these cardiovascular events returned normal after anesthesia. The respiratory adverse events occurred in 72 cases, including cough (49), breath holding (10), partial airway obstruction (8), hypoxia (4), and laryngospasm (1). None of the patients had bronchospasm. Most of the respiratory adverse events could be controlled by manual ventilation with mask, and oropharyngeal airway or laryngeal mask insertion. In four cases with hypoxia, the duration was less than 1 minute and these cases were no eventful after anesthesia.
CONCLUSION
VIMA without I.V. access can be effective in brief procedures with mild to moderate burn-injured pediatric patients, even though a longer period of study may be required to assess the efficacy and safety.

Keyword

Burn; Children; Inhalation anesthesia; Intravenous; Sevoflurane

MeSH Terms

Airway Obstruction
Anesthesia
Anesthesia, Inhalation
Anoxia
Arrhythmias, Cardiac
Bradycardia
Breath Holding
Bronchial Spasm
Burns
Child
Cicatrix, Hypertrophic
Cough
Humans
Hypertension
Laryngeal Masks
Laryngismus
Masks
Medical Staff
Methyl Ethers
Parents
Tachycardia
Ventilation
Methyl Ethers
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