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Anesth Analg 2006;102:1699-1702
© 2006 International Anesthesia Research Society
doi: 10.1213/01.ane.0000205749.92049.91

ANESTHETIC PHARMACOLOGY

Onset Time for Sevoflurane/Nitrous Oxide Induction in Adults Is Prolonged with Increasing Age

Michael C. Lewis, MD, Ricardo I. Gerenstein, MD, and Gilbert Chidiac, MD

Department of Anesthesiology, University of Miami, Miami, Florida; Division of Anesthesiology, Cleveland Clinic Florida, Weston Florida

Address correspondence and reprint requests to Michael C. Lewis, MD, Department of Anesthesiology, Miller School of Medicine at the University of Miami, P.O. Box 016370 (R-370) Miami FL 33101. Address e-mail to mclewis{at}med.miami.edu.

Inhaled induction of anesthesia is occasionally used in adults. Using a modified vital capacity sevoflurane/nitrous oxide (N2O) inhaled induction, we evaluated the effect of increasing age on the onset time of anesthesia. Twenty patients, aged 26-65 yr, performed a vital capacity breath followed by regular tidal breathing from an anesthesia circuit primed with sevoflurane 8%/N2O/O2. The following values were recorded: time to loss of eyelash reflex (LOER); time to bispectral index ≤60 (BIS ≤60); expired fraction of sevoflurane at the time of induction, LOER and BIS ≤60. The mean times and 95% confidence intervals to LOER and BIS ≤60 were 54 s (37-70 s) and 175 s (143-207 s), respectively, and were significantly prolonged by aging (r = 0.65; P = 0.002). Times to LOER and BIS ≤60, predicted from the regression line, were 3.9 and 2 times longer in a 60-yr-old than in a 30-yr-old patient. The expired fraction of sevoflurane measured at time to LOER and BIS ≤60 decreases with increase in age. We conclude that inhaled induction with sevoflurane/N2O is dramatically prolonged with increased age.




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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 © 2006 by the International Anesthesia Research Society.