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Anesth Analg 2008; 106:1122-1125
© 2008 International Anesthesia Research Society
doi: 10.1213/01.ane.0000286174.07844.e9
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PEDIATRIC ANESTHESIOLOGY

A Comparison of the End-Tidal Sevoflurane Concentration for Removal of the Laryngeal Mask Airway and Laryngeal Tube in Anesthetized Children

Jeong-Rim Lee, MD, Young-Sun Lee, MD, Chong Sung Kim, MD, PhD, Seong Deok Kim, MD, PhD, and Hee-Soo Kim, MD, PhD

From the Department of Anesthesiology, Seoul National University College of Medicine, Seoul, Korea.

Address correspondence and reprint requests to Hee-Soo Kim, MD, PhD, Department of Anesthesiology, Seoul National University College of Medicine, Seoul, Korea, # 28 Yongondong, Jongrogu, Seoul, Korea. Address e-mail to dami0605{at}snu.ac.kr.

Abstract

BACKGROUND: In this study we quantified and compared the optimal sevoflurane concentration required to prevent coughing or moving during or after removal of the laryngeal mask airway (LMA) and the laryngeal tube (LT) in anesthetized children.

METHODS: Forty unpremedicated children, aged 8 mo to 12 yr, were randomly allocated to receive the LMA or LT. General anesthesia was induced via mask with sevoflurane and the LMA or LT was inserted. Anesthesia was maintained with sevoflurane and oxygen. At the end of surgery, a predetermined end-tidal sevoflurane concentration was maintained for at least 10 min and the LMA or LT was removed. Using Dixon’s up-down method, the concentration for LMA and LT removal was determined by adjusting the dose by a 0.2% increment. Success was defined by the absence of coughing, teeth clenching, gross purposeful movement, breath holding, laryngospasm, and desaturation.

RESULTS: The end-tidal concentration of sevoflurane to achieve successful LMA removal in 50% of children was 1.90%, in 95% of children was 2.15%. For the LT, the concentrations were 1.83% and 2.00%. The 50% effective dose values did not differ significantly between groups.

CONCLUSIONS: LMA and LT removal in 95% of anesthetized children (aged 8 mo to 12 yr) can be safely accomplished without coughing, moving, or any other airway complications at 0.86 and 0.80 minimum alveolar anesthetic concentration, respectively, and a similar concentration should be used for removal of the LT or LMA in children.






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 © 2008 by the International Anesthesia Research Society.