Does the addition of nitrous oxide improve sevoflurane induction of anesthesia in children?

ABSTRACT

Recently, with the introduction of sevoflurane and owing to its ease and speed of induction together with the lack of the pungent irritating odour, all these factors made sevoflurane ideal for inhalation induction in children. Nitrous oxide was known to augment the effect of all inhaled anesthetic agents. The present study tested the hypothesis that N[2]O could facilitate induction and tracheal intubation conditions with 8% sevoflurane in children. The study included 60 children aged 3-10 years divided into 3 groups to undergo inhalation induction with 8% sevoflurane in 50% N[2]O, 66% N[2]O, and 100% oxygen for the three involved groups. Induction time was shortest in group II [66% N[2]O] [46.4 +/- 6.08 s] and longest in group III [100% O[2]] [72. 75 +/- 11.09 s]. Intubation conditions were best in group II with the least complication rate [15%] while group III reported 60% complication rate. Hemodynamically, no clinically important changes were recorded. The study concluded that the use of inhalation induction with 8% sevoflurane in 66% N[2]O was safe in a sense of fast and least eventful induction with easy and favourable intubating conditions in children undergoing elective surgery