Logo Medical Science Monitor

Call: +1.631.470.9640
Mon - Fri 10:00 am - 02:00 pm EST

Contact Us

Logo Medical Science Monitor Logo Medical Science Monitor Logo Medical Science Monitor

24 October 2019 : Clinical Research  

Minimum Alveolar Concentration of Sevoflurane with Cisatracurium for Endotracheal Intubation in Neonates

Bin Zhang1ABCDEF, Junxia Wang2ABCDEF, Mingzhuo Li3ABCDEF, Feng Qi1ABCDEFG*

DOI: 10.12659/MSM.917472

Med Sci Monit 2019; 25:7982-7988

Abstract

BACKGROUND: Sevoflurane inhalation induction is widely used in pediatric anesthesia, but the minimum alveolar concentration for endotracheal intubation (MACEI) when combined with neuromuscular blockade in neonates has been largely unexplored. This study assessed the MACEI of sevoflurane combined with cisatracurium in neonates.

MATERIAL AND METHODS: Anesthesia induction was commenced by inhaling 4% sevoflurane with 2 l/min of 100% oxygen via mask. Neonates were administered cisatracurium 0.2 mg/kg followed by adjustment of inspired sevoflurane to target end-tidal concentration based on intubation condition of the preceding subject. When the steady-state end-tidal sevoflurane concentration target was maintained for at least 15 min, endotracheal intubation by direct laryngoscope was performed. The intubation condition was considered failed if either heart rate (HR) after intubation increased by 20% or mean arterial blood pressure (MAP) by 30% or more than that before intubation. Otherwise, the intubation condition was regarded as successful. Dixon’s up-and-down method was used with 0.2% as the step size to determine the target end-tidal sevoflurane concentration.

RESULTS: The MACEI of sevoflurane combined with cisatracurium in neonates was 2.76±0.24%. Using probit analysis, the 50% effective end-tidal sevoflurane concentration (ED50) for successful condition of endotracheal intubation was 2.61% (95%CI 2.07–2.88%) and the 95% effective end-tidal sevoflurane concentration (ED95) was 3.28% (95%CI 2.95–7.19%). Hypotension and bradycardia occurred in 2 neonates during induction.

CONCLUSIONS: Sevoflurane combined with cisatracurium is feasible and effective for intubation in neonates, and the MACEI of sevoflurane in this subpopulation is 2.76±0.24%. However, cardiovascular adverse effects should be taken into consideration.

Keywords: Anesthetics, Atracurium, Infant, Newborn, Intubation, Dose-Response Relationship, Drug, Heart Rate, Intubation, Intratracheal, Pulmonary Alveoli, sevoflurane

Add Comment 0 Comments

986 18

Editorial

01 September 2023 : Editorial  

Editorial: A Rapid Global Increase in COVID-19 is Due to the Emergence of the EG.5 (Eris) Subvariant of Omicron SARS-CoV-2

Dinah V. Parums
Science Editor, Medical Science Monitor, International Scientific Information, Inc., Melville, NY, USA

DOI: 10.12659/MSM.942244

Med Sci Monit 2023; 29:e942244

0:00

In Press

22 Sep 2023 : Clinical Research  

Comparative Analysis of Symptomatology in Hospitalized Children with RSV, COVID-19, and Influenza Infections

Med Sci Monit In Press; DOI: 10.12659/MSM.941229  

21 Sep 2023 : Clinical Research  

The Impact of Implementing the Vortex Approach on Airway Management Performance in Stressed Medical Student...

Med Sci Monit In Press; DOI: 10.12659/MSM.940372  

20 Sep 2023 : Clinical Research  

Changes in Upper Airway Anatomy Following Orthodontic Treatment for Malocclusion: A Comparative Retrospecti...

Med Sci Monit In Press; DOI: 10.12659/MSM.941749  

20 Sep 2023 : Database Analysis  

Comparative Finite Element Analysis of Endocrowns and Traditional Restorations for Endodontically Treated M...

Med Sci Monit In Press; DOI: 10.12659/MSM.941314  

Most Viewed Current Articles

13 Nov 2021 : Clinical Research  

Acceptance of COVID-19 Vaccination and Its Associated Factors Among Cancer Patients Attending the Oncology ...

DOI :10.12659/MSM.932788

Med Sci Monit 2021; 27:e932788

0:00

30 Dec 2021 : Clinical Research  

Retrospective Study of Outcomes and Hospitalization Rates of Patients in Italy with a Confirmed Diagnosis o...

DOI :10.12659/MSM.935379

Med Sci Monit 2021; 27:e935379

08 Mar 2022 : Review article  

A Review of the Potential Roles of Antioxidant and Anti-Inflammatory Pharmacological Approaches for the Man...

DOI :10.12659/MSM.936292

Med Sci Monit 2022; 28:e936292

01 Jan 2022 : Editorial  

Editorial: Current Status of Oral Antiviral Drug Treatments for SARS-CoV-2 Infection in Non-Hospitalized Pa...

DOI :10.12659/MSM.935952

Med Sci Monit 2022; 28:e935952

Your Privacy

We use cookies to ensure the functionality of our website, to personalize content and advertising, to provide social media features, and to analyze our traffic. If you allow us to do so, we also inform our social media, advertising and analysis partners about your use of our website, You can decise for yourself which categories you you want to deny or allow. Please note that based on your settings not all functionalities of the site are available. View our privacy policy.

Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750