Canadian journal of anaesthesia = Journal canadien d'anesthesie · 2002
Caudal anesthesia reduces the minimum alveolar concentration of enflurane for laryngeal mask airway removal in boys.
Клиническое исследованиеСтатьяРандомизированное исследованиеНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Xiao Wen-Jing, Deng Xiao-Ming, Tang Geng-Zhi, Lu Mao-Ping, Xu Kun-Ling
Аннотация
PURPOSE: To investigate the effects of caudal analgesia on the minimal alveolar concentration of enflurane for laryngeal mask airway (LMA) smooth extubation (MACex).
METHODS: We studied 50 nonpremedicated children, aged three to ten years, ASA physical status I, undergoing surgery for hypospadias repair. After a sevoflurane inhalation induction, children were randomized to receive LMA insertion with or without ropivacaine caudal analgesia. At the end of surgery, a predetermined end-tidal enflurane concentration was achieved, and the LMA was removed by an anesthesiologist blinded to group allocation. Each concentration at which LMA extubation was attempted was predetermined by the up-and-down method (with 0.1% as the step size). When LMA removal was accomplished without coughing, clenching teeth or gross purposeful muscular movements during or within one minute after removal, it was considered successful.
RESULTS: MACex of enflurane for LMA removal in the group without caudal anesthesia was 1.04% (95% confidence interval, 1.00-1.10) and the LMA MACex of enflurane in the group with caudal anesthesia was 0.74% (95% confidence interval, 0.63-0.81). Caudal analgesia significantly reduced enflurane requirements by 29% (95% confidence interval, 22-36%).
CONCLUSION: In conclusion, caudal analgesia significantly reduced the LMA MACex of enflurane by approximately 29%. Possible mechanisms may be related to the analgesic effect of caudal blockade or to the sedative properties of neuraxial anesthesia.
METHODS: We studied 50 nonpremedicated children, aged three to ten years, ASA physical status I, undergoing surgery for hypospadias repair. After a sevoflurane inhalation induction, children were randomized to receive LMA insertion with or without ropivacaine caudal analgesia. At the end of surgery, a predetermined end-tidal enflurane concentration was achieved, and the LMA was removed by an anesthesiologist blinded to group allocation. Each concentration at which LMA extubation was attempted was predetermined by the up-and-down method (with 0.1% as the step size). When LMA removal was accomplished without coughing, clenching teeth or gross purposeful muscular movements during or within one minute after removal, it was considered successful.
RESULTS: MACex of enflurane for LMA removal in the group without caudal anesthesia was 1.04% (95% confidence interval, 1.00-1.10) and the LMA MACex of enflurane in the group with caudal anesthesia was 0.74% (95% confidence interval, 0.63-0.81). Caudal analgesia significantly reduced enflurane requirements by 29% (95% confidence interval, 22-36%).
CONCLUSION: In conclusion, caudal analgesia significantly reduced the LMA MACex of enflurane by approximately 29%. Possible mechanisms may be related to the analgesic effect of caudal blockade or to the sedative properties of neuraxial anesthesia.