A. Güner ERPEK, Feray GÜRSOY, Nil KURT, Ayşe GÜREL

Çocuklarda iki farklı yöntemle kullanılan sevofluran ve halotanın indüksiyon özelliklerinin karşılaştırılması

Çalışmada pediyatrik hastalarda inhalasyon yoluyla anestezi indüksiyonu için halotan ve sevofluranı farklı iki yöntemle uygulayarak indüksiyon özelliklerinin karşılaştırılması planlandı. Yaşları 1-10 arası, ASA I-II grubu 160 pediyatrik hasta kullanılan inhalasyon anesteziğine ve konsantrasyonuna göre randomize olarak dört gruba ayrıldı. Grup I'de (n=40) % l konsantrasyonda sevofluran ile başlanıp her 2-3 nefeste bir %1 arttırılarak % 8'e, Grup H'de (n=40): % 0.5 konsantrasyonda halotan ile başlanıp her 2-3 nefeste bir % 0.5 arttırılarak % 5'e çıkıldı. Grup III'de (n=40) % 8 konsantrasyonda sevofluran ve Grup IV'de (n=40) % 5 konsantrasyonda halotan uygulanarak indüksiyon gerçekleştirildi. Tüm gruplarda inhalasyonla indüksiyon ajanı toplam 9 L $dk^{-1}$ % 33 oksijen ve % 67 N2O karışımı içinde uygulandı. Kalp atım hızı, ortalama arter basıncı, SpO2, kirpik refleksi kaybı ve pupillaların orta hatta gelmesi için geçen süreler kayıt edildi. Pupillalar orta hatta geldikten sonra damar yolu açıldı, indüksiyon döneminde görülen ajitasyon, nefes tutma, öksürük, bulantı, kusma, laringospazm, bronkospazm ve aritmi gibi komplikasyonlar kaydedildi. Yüksek konsantrasyonda sevofluran ve halotan ile (Grup III ve TV) kirpik refleksi kaybı süresi artan konsantrasyonda sevofluran ve halotana (Grup I ve II) göre daha kısaydı (p

Anahtar Kelimeler:

Çocuk, Halotan, Anestezikler, inhalasyon

Comparison of induction characteristics of sevoflurane and halothane induction administered in two different methods

The aim of this study was to compare induction characteristics of sevoflurane and halothane administered in two different methods in pediatric patients. One hundered and sixty children (aged 1-10 and ASA I-II) were randomized into four groups. In Group I (n=40), children initially received sevoflurane 1 % followed by 1 % increases in every 2-3 breaths up to 8 % during anesthesia induction. In Group II (n=40), children initially received halothane 0.5% followed by 0.5 % increases in every 2-3 breaths up to 5 % during induction. In Group HI (n=40) and IV (n=40), the patients directly received sevoflurane 8 % and halothane 5 % respectively. In all groups, the inhalation agent during induction was administered in a mixture of oxygen 33 % and N2O 67 % at 9 L $min^{-1}$ rate. The pulse rate, mean arterial blood pressure, SpO2 and time f or loss of eyelash reflex and fixation of pupils at midline were recorded. Intravenous line access was set after fixation of pupils at midline. Agitation, breath holding, cough, nausea, vomiting, laryngospasm, bronchospasm and cardiac arrhythmia during induction period were also noted. The time to loss of eyelash reflex was found to be shorter in high concentration groups (Group III and IV) than incremental concentration groups (Group I and II) (p<0.05). Halothane had a faster induction rate than sevoflurane in the incremental concentration metod. The mean pulse rate was slower in halothane groups than in sevoflurane groups (p<0.05). Decrease in mean arterial blood pressure was observed in all groups. There was no difference in complications between groups. In conclusion, as there was no significant difference during induction phase between sevoflurane and halothane. We suggest that choice of inhalation agent should be made on patients clinical status.

Keywords:

Child, Halothane, Anesthetics, Inhalation,

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