Mehmet Emin ORHAN, Ferruh BİLGİN, Oğuz KILIÇKAYA, Abdulkadir ATIM, Ercan KURT

5840

Nitrous oxide anesthesia in children for MRI: a comparison with isoflurane and halothane

To compare the anesthetic effects of nitrous oxide, isoflurane, and halothane on hemodynamic stability and recovery characteristics in pediatric patients during magnetic resonance imaging (MRI). Materials and methods: The present study includes 60 ASA I-II children aged 1-12 years undergoing MRI. After endotracheal intubation, patients were randomly assigned into 1 of 3 anesthetic groups. Group N (n = 20) received nitrous oxide and oxygen (N2O:O2 60:40), Group I (n = 20) received 0.5% isoflurane and oxygen, Group H (n = 20) received 0.5% halothane and oxygen to maintain anesthesia. At the completion of the procedure, inhalation anesthetic was discontinued. Extubation, emergence, recovery times, and adverse events were recorded throughout the duration of the procedure. Results: There was no significant difference in the demographic data among the groups. In the nitrous oxide group 5 children (25%), in the halothane group 2 children (10%), and in the isoflurane group 1 child (5%) moved during MRI and supplemental inhalation anesthesia was required for these patients. Emergence time after nitrous oxide anesthesia was slightly shorter than after isoflurane anesthesia (3.15 ± 2.56 min compared with 4.65 ± 2.64 min, P = 0.162) but significantly shorter than after halothane anesthesia (5.35 ± 2.47 min, P = 0.023). Early recovery time after nitrous oxide and isoflurane anesthesia was significantly more rapid than after halothane anesthesia (4.60 ± 2.58 min and 3.65 ± 1.63 min compared with 7.00 ± 2.15 min, P < 0.05). Conclusion: After induction with propofol, nitrous oxide may provide anesthesia for MRI in pre-medicated children. However, complete immobility was not achieved in all patients with nitrous oxide alone. Nitrous oxide and isoflurane resulted in faster emergence and recovery than halothane, but there was no significant difference between nitrous oxide and isoflurane. Discharge times from the hospital were similar for all 3 groups.
Anahtar Kelimeler:

Key words: Magnetic resonance imaging, pediatrics, anesthesia, nitrous oxide, isoflurane, halothane, recovery

Nitrous oxide anesthesia in children for MRI: a comparison with isoflurane and halothane

To compare the anesthetic effects of nitrous oxide, isoflurane, and halothane on hemodynamic stability and recovery characteristics in pediatric patients during magnetic resonance imaging (MRI). Materials and methods: The present study includes 60 ASA I-II children aged 1-12 years undergoing MRI. After endotracheal intubation, patients were randomly assigned into 1 of 3 anesthetic groups. Group N (n = 20) received nitrous oxide and oxygen (N2O:O2 60:40), Group I (n = 20) received 0.5% isoflurane and oxygen, Group H (n = 20) received 0.5% halothane and oxygen to maintain anesthesia. At the completion of the procedure, inhalation anesthetic was discontinued. Extubation, emergence, recovery times, and adverse events were recorded throughout the duration of the procedure. Results: There was no significant difference in the demographic data among the groups. In the nitrous oxide group 5 children (25%), in the halothane group 2 children (10%), and in the isoflurane group 1 child (5%) moved during MRI and supplemental inhalation anesthesia was required for these patients. Emergence time after nitrous oxide anesthesia was slightly shorter than after isoflurane anesthesia (3.15 ± 2.56 min compared with 4.65 ± 2.64 min, P = 0.162) but significantly shorter than after halothane anesthesia (5.35 ± 2.47 min, P = 0.023). Early recovery time after nitrous oxide and isoflurane anesthesia was significantly more rapid than after halothane anesthesia (4.60 ± 2.58 min and 3.65 ± 1.63 min compared with 7.00 ± 2.15 min, P < 0.05). Conclusion: After induction with propofol, nitrous oxide may provide anesthesia for MRI in pre-medicated children. However, complete immobility was not achieved in all patients with nitrous oxide alone. Nitrous oxide and isoflurane resulted in faster emergence and recovery than halothane, but there was no significant difference between nitrous oxide and isoflurane. Discharge times from the hospital were similar for all 3 groups.
Keywords:

Key words: Magnetic resonance imaging, pediatrics, anesthesia, nitrous oxide, isoflurane, halothane, recovery,

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  • Serafi ni G, Zadra N. Anaesthesia for MRI in paediatric patient. Curr Opin Anaesthesiol 2008; 21: 499-503. 2. Davis C, Razavi R, Baker EJ. Sedation versus general anaesthesia for MRI scanning in children. Arch Dis Child 2000; 83: 276. 3. Byrne AT. Paediatric MRI. Curr Anaesth Crit Care 2008; 19: 315-8.
  • Gupta A, Stierer T, Zuckerman R, Sakima N, Parker SD, Fleisher LA. Comparison of recovery profi le aft er ambulatory anesthesia with propofol, isofl urane, sevofl urane and desfl urane: a systematic review. Anesth Analg 2004; 98: 632-41. 5. Dahmani S, Stany I, Brasher C, Lejeune C, Bruneau B, Wood C et al. Pharmacological prevention of sevofl urane- and desfl urane-related emergence agitation in children: a meta- analysis of published studies. Br J Anaesth 2010; 104: 216-23.
  • Cravero J, Surgenor S, Whalen K. Emergence agitation in paediatric patients aft er sevofl urane anaesthesia and no surgery: a comparison with halothane. Paediatr Anaesth 2000; 10: 419-24.
  • Kuratani N, Oi Y. Greater incidence of emergence agitation in children aft er sevofl urane anesthesia as compared with halothane: a meta-analysis of randomized controlled trials. Anesthesiology 2008; 109: 225-32.
  • Bortone L, Ingelmo P, Grossi S, Grattagliano C, Bricchi C, Barantani D et al. Emergence agitation in preschool children: double-blind, randomized, controlled trial comparing sevofl urane and isofl urane anesthesia. Paediatr Anaesth 2006; 16: 1138-43.
  • Davis PJ, Cohen IT, McGowan FX Jr, Latta K. Recovery characteristics of desfl urane versus halothane for maintenance of anesthesia in pediatric ambulatory patient. Anethesiology 1994; 80: 298-302.
  • Voepel-Lewis T, Malviya S, Tait AR. A prospective cohort study of emergence agitation in the pediatric postanesthesia care unit. Anesth Analg 2003; 96: 1625-30.
  • Hopkins PH. Nitrous oxide: a unique drug of continuing importance for anaesthesia. Best Pract Res Clin Anesthesiol 2005; 19: 381-9.
  • Milesi C, Pidoux O, Sabatier E, Badr M, Cambonie G, Picaud JC. Nitrous oxide analgesia for intubating preterm neonates: A pilot study. Acta Paediatr 2006; 95: 1104-8.
  • Barr G, Jakobsson JG, Öwall A, Anderson RE. Nitrous oxide does not alter bispectral index: study with nitrous oxide as sole agent and as an adjunct to i.v. anaesthesia. Br J Anaesth 1999; 82: 827-30.
  • Coste C, Guignard B, Menigaux C, Chauvin M. Nitrous oxide prevents movement during orotracheal intubation without aff ecting BIS value. Anaest Analg 2000; 91: 130-5.
  • Vila R, LIoret J, Munar F, Vinzo J. Spinal anaesthesia for inguinal herniotomy in preterm infants sedated with nitrous oxide: a comparison of lumbar puncture in the lateral or sitting position. Anaesthesia 2002; 57: 1164-7.
  • Zier JL, Drake GJ, McCormick PC, Clinch KM, Cornfi eld DN. Case-series of nurse-administered nitrous oxide for urinary catheterization in children. Anesth Analg 2007; 104: 876-9.
  • Wood M. Th e safety and effi cacy of intranasal midazolam sedation combined with inhalation sedation with nitrous oxide and oxygen in paediatric dental patients as an alternative to general anaesthesia. SAAD Dig 2010; 26: 12-22.
  • Aldrete JA, Kroulik D. A postanesthetic recovery score. Anesth Analg 1970; 49: 924-34.
  • Weldon BC, Bell M, Craddock T. Th e eff ect of caudal analgesia on emergence agitation in children aft er sevofl urane versus halothane anesthesia. Anesth Analg 2004; 98: 321-6.
  • Greenberg JA, Davis PJ. Premedication and induction of anesthesia in pediatric surgical patients. Anesthesiol Clin North America 1996; 14: 781-802.
  • Olmos M, Ballester JA, Vidatre MA, Elizalde JL, Escobar A. Th e combined eff ect of age and premedication on the propofol requirements for induction by target-controlled infusion. Anesth Analg 2000; 90: 1157-61.
  • Wolf WJ, Neal MB, Peterson MD. Th e hemodynamic and cardiovascular eff ects of isofl urane and halothane anesthesia in children. Anesthesiology 1986; 64: 328-33.
  • Rivenes SM, Lewin MB, Stayer SA, Bent ST, Schoenig HM, McKenzie ED et al. Cardiovascular eff ects of sevofl urane, isofl urane, halothane, and fentanyl-midazolam in children with congenital heart disease: an echocardiographic study of myocardial contractility and hemodynamics. Anesthesiology 2001; 94: 223-9.
  • Dalal PG, Corner A, Chin C, Wood C, Razavi R. Comparison of the cardiovascular eff ects of isofl urane and sevofl urane as measured by magnetic resonance imaging in children with congenital heart disease. J Clin Anesth 2008; 20: 40-4.
  • Fisher DM, Robinson S, Brett CM, Perin G, Gregory GA: Comparison of enfl urane, halothane, and isofl urane for diagnostic and therapeutic procedures in children with malignancies. Anesthesiology 1985; 63: 647-650.
  • Emhardt JD, Saysana C, Sirichotvithyakorn P. Anesthetic considerations for pediatric outpatient surgery. Semin Pediatr Surg 2004; 13: 210-21.
  • Hallen J, Rawal N, Gupta A. Postoperative recovery following outpatient pediatric myringotomy: A comparison between sevofl urane and halothane. J Clin Anest 2001; 13: 161-6.
  • Cox RG, Nemish U, Ewen A, Crowe MJ. Evidence-based clinical update: does premedication with oral midazolam lead to improved behavioural outcomes in children. Can J Anesth 2006; 53: 1213-9.
  • Sandner-Kiesling A, Schwarz G, Vicenzi M, Fall A, James RL, Ebner F, List WF. Side-eff ects aft er inhalational anaesthesia for paediatric cerebral magnetic resonance imaging. Paediatr Anaesth 2002; 12: 429-37.
  • Murray DJ, Schmid CM, Forbes RB. Anesthesia for magnetic resonance imaging in children: a low incidence of protracted post-procedure vomiting. J Clin Anesth 1995; 7: 232-6.
  • Bhatt R, Child V, Kurli M, Musadiq M, Johns S, Stoot M, Sandramouli S. Use of inhaled nitrous oxide for minor eyelid surgery: A placebo-controlled study. Orbit 2003; 22: 177-82.
  • Silva LM, Braz LG, Módolo NS. Emergence agitation in pediatric anesthesia: current features. J Pediatr (Rio J) 2008; 84: 107-113
  • Dahmani S, Stany I, Brasher C, Lejeune C, Bruneau B, Wood et al. Pharmacological prevention of sevofl urane and desfl urane related emergence agitation in children: a meta-analysis of published studies. Br J Anaesth 2010; 104: 216-23.
Turkish Journal of Medical Sciences-Cover
  • ISSN: 1300-0144
  • Yayın Aralığı: Yılda 6 Sayı
  • Yayıncı: TÜBİTAK
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