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KMID : 0878620030070020076
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Korean Journal of Pediatric Anesthesia
2003 Volume.7 No. 2 p.76 ~ p.81
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The Differences of the MAC incision of Wevolurane between Infant and Children with the Intravenous Induction of Ketamine
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Han Jong-In
Kim Chi-Hyo
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Abstract
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Background : We have investigated the hemodynamic response to surgical incision under intravenous induction with ketamine followed by sevoflurane inhalation anesthesia for induction and maintenance for children because we want to know that sevoflurane MAC_(incision)(the minimun alveolar concentration of sevoflurance that block the responses to surgical incision) is different according to the age ( 1 and under 1 year or over 1 year) under ketamine induction.
Methods : Forty children (classified as ASA physical status 1 or 2) scheduled for elective inguinal herniorrhaphy were devided into two groups (Infants vs children). After intravenous induction with ketamine 2 mg/kg all patients were under controlled ventilation with rocuronium 0.4 mg/kg and sevoflurane 5.0 vol%. After 2 minute ventilation, endotrachel intubation was performed and the concentration of sevoflurance was decreased to 2 vol% with N_(2)O : O_(2) of 2L : 2L and maintained until skin incision performed. After skin incison, inspiratory fraction of sevoflurane was increased or decreased according to the change of heart rate. We recorded the end tidal concentration of sevoflurane, blood pressure, and hear rate before induction, after induction, intubation, and skin incision, 5 minute after skin incision and 10 minute after skin incision.
Results : FEsevo (expired fraction of sevoflurane) in 5 minute after skin incision was significantly different between two groups (1.80 ±0.22 vol% in infants, 1.97±0.26 vol% in children, P=0.032)and FEsevo in 10 minutes after skin incision was also different between two groups (1.57±0.32 vol% in infants, 1.84±0.36 vol% in children P=0.0143).
Conclusion : MAC_(incision) of sevoflurane after ketamine induction of infants are lower than that of sevoflurane in children. so smaller maintenance dose of sevoflurane is needed in infants compared as in children after ketamine induction in inguinal repair patients.
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KEYWORD
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ketamine, sevoflurane, pediatric, minimum alveolar concentration, heart rate
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