Inhalation induction with sevoflurane in adult cardiac surgery patients. A case series

ABSTRACT

Introduction: Anesthesia induction through volatile agents is a well-established technique in several fields butnot in adult patients undergoing cardiac surgery. Successful inhalation induction requires a poorly soluble, reasonablypotent and minimally irritant agent, and the benefits associated to this technique include reduced incidenceof hypothermia and hypotension and lower costs when compared to some intravenous anesthetics agents.Methods: Fifty-six patients undergoing coronary artery bypass grafting were observed at the induction ofgeneral anesthesia with sevoflurane in oxygen by facial mask. All patients received 2% sevoflurane in 100%oxygen initially for 30 seconds. The inspired concentration of sevoflurane was increased to 7% until loss ofconsciousness and then reduced back to 2%. Next, intravenous 0.5 ìg/kg sufentanil and 0.1 mg/kg pancuroniumwere administered. Volume-controlled ventilation was started before tracheal intubation.Results: All 56 patients tolerated the inhalational induction. No patient presented signs of airway irritation.Hypotension occurred in 30 patients and was managed with low dose phenylephrine.Conclusions: This case series showed that inhalation induction is feasible and safe even in adult patientsundergoing cardiac surgery.