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Anesth Analg 2005;101:1615-1618
© 2005 International Anesthesia Research Society
doi: 10.1213/01.ANE.0000184134.80849.17

PEDIATRIC ANESTHESIA

Airway Protective Reflexes Evoked by Laryngeal Instillation of Distilled Water Under Sevoflurane General Anesthesia in Children

Teruhiko Ishikawa, MD, Shiroh Isono, MD, Atsuko Tanaka, MD, Yugo Tagaito, MD, and Takashi Nishino, MD

Department of Anesthesiology (B1), Chiba University Graduate School of Medicine, Tokyo, Japan

Address correspondence and reprint requests to Teruhiko Ishikawa, MD, Department of Anesthesiology (B1), Chiba University Graduate School of Medicine, 1–8–1 Inohana, Chuo-ku, Chiba 260-8677, Japan. Address e-mail to tishikawa{at}faculty.chiba-u.jp.

To investigate how sevoflurane modifies airway protective reflexes in anesthetized children, we recruited patients younger than 12-yr-old for our study. Anesthesia was induced with inhaled sevoflurane in oxygen. The airway was managed with a laryngeal mask airway and the patient breathing spontaneously. Depending on the depth of anesthesia, the subjects were divided into two groups: Group 1 and Group 2 (1% and 2% of end-tidal sevoflurane concentration, respectively). Behaviors of the larynx were assessed mainly by the fiberscopic images of the larynx as well as respiratory flow and esophageal pressure. A small dose, 0.02 mL/kg of distilled water (minimum 0.2 mL) was instilled to the larynx through a channel of the scope to evoke an airway protective reflex from the larynx. The responses were categorized into passive (laryngeal closure, laryngospasm, and apnea) and active (cough, expiration reflex, and swallowing reflex) responses. Ten subjects were included in each group. In both groups, the primary responses were passive; however, in Group 1, active reflexes were also observed in 8 of 10 subjects; no subjects in Group 2 had active reflexes (P < 0.01). We concluded that, in children, the depth of general anesthesia with sevoflurane modified airway protective reflexes.




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J.-R. Lee, S.-D. Kim, C.-S. Kim, T.-G. Yoon, and H.-S. Kim
Minimum Alveolar Concentration of Sevoflurane for Laryngeal Mask Airway Removal in Anesthetized Children
Anesth. Analg., March 1, 2007; 104(3): 528 - 531.
[Abstract] [Full Text] [PDF]


Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2005 by the International Anesthesia Research Society.