Fritsch Nicolas, Nouette-Gaulain Karine, Bordes Maryline, Semjen Francois, Meymat Yves, Cros Anne-Marie
Department of anesthesia 4, Hôpital Pellegrin, CHU Bordeaux, Bordeaux, France.
Paediatr Anaesth. 2009 Feb;19(2):126-32. doi: 10.1111/j.1460-9592.2008.02802.x.
Target-controlled inhalation induction (TCII) with sevoflurane is becoming possible with new anesthesia platforms. Although TCII has already been performed in adults, it remains to be evaluated in children.
In a prospective study, we compared TCII using the Felix AInOC anesthetic station (Taema, Anthony, France) to our standard protocol inhalation induction in children scheduled for elective surgery under general anesthesia. After preoxygenation, sevoflurane induction was performed in both groups without priming of the circuit. Sufentanil was administered after venous line placement.
In the TCII group, no overdosage or underdosage was observed except in two children where TCII failed owing to high agitation, and the number of adjustments was lower compared with our standard protocol inhalation induction (1(1-2.5[0-5]) vs 6(5-6[4-10]) respectively). Moreover, the delay to obtain target end-tidal sevoflurane concentration was shorter in the TCII group (2(1.6-2.7[1.3-4]) min vs 3.4(2.5-3.8[2.3-6.5]) min respectively). No significant difference in the delay of loss of consciousness or in the conditions for intubation or laryngeal mask placement was observed between the groups.
The Felix AInOC allows TCII to be performed satisfactorily in children. Manual inhalation induction induced a higher number of adjustments and overdosages.
随着新的麻醉平台的出现,使用七氟醚进行靶控吸入诱导(TCII)已成为可能。尽管TCII已在成人中实施,但在儿童中仍有待评估。
在一项前瞻性研究中,我们将使用Felix AInOC麻醉工作站(法国安东尼市泰玛公司)进行的TCII与我们在计划接受全身麻醉下择期手术的儿童中的标准吸入诱导方案进行了比较。预充氧后,两组均在未预充回路的情况下进行七氟醚诱导。在放置静脉通路后给予舒芬太尼。
在TCII组中,除两名因高度躁动导致TCII失败的儿童外,未观察到用药过量或不足的情况,且与我们的标准吸入诱导方案相比,调整次数更少(分别为1(1 - 2.5[0 - 5])次与6(5 - 6[4 - 10])次)。此外,TCII组达到目标呼气末七氟醚浓度的延迟时间更短(分别为2(1.6 - 2.7[1.3 - 4])分钟与3.4(2.5 - 3.8[2.3 - 6.5])分钟)。两组之间在意识消失延迟、插管或放置喉罩的条件方面未观察到显著差异。
Felix AInOC可使TCII在儿童中令人满意地实施。手动吸入诱导导致更多的调整次数和用药过量情况。