Introduction: Pediatric anesthesia induction with sevoflurane usually needs a special vaporizer and gas source, which limits its use to the operating room (OR). Many children feel anxious and cry when entering the OR because of being separated from their parents, which impairs anesthesia safety and their physical and mental health. In this study, we used a portable circuit to perform sevoflurane anesthesia induction outside the OR, assessed its effects and compared them with those of ketamine anesthesia in pediatric patients.
Material and methods: We performed anesthesia induction in 100 children outside the OR, with either sevoflurane (sevoflurane group) through the portable inhalational anesthetic circuit, or ketamine by intramuscular injection (ketamine group), then transferred the patients to the OR. Peak inspired concentration (Cp) and steady state concentration (Cs) of sevoflurane were measured. Heart rate (HR) and saturation of peripheral oxygen (SpO₂) were monitored before anesthesia, on arrival at the OR, and at the end of the operation. Time for anesthesia induction, awakening, leaving the OR, and duration of the operation were recorded. Score of reaction during venepuncture, number of noncooperation cases during anesthesia induction, and side effects were also analyzed.
Results: The Cp and Cs of sevoflurane were correlated with bodyweight. Compared with the ketamine group, the sevoflurane group showed shorter time for anesthesia induction, awakening and leaving the OR, less noncooperation during anesthesia induction, lower HR and higher SpO₂ on arrival at the OR.
Conclusions: Pediatric anesthesia induction by sevoflurane with the portable inhalational anesthetic circuit is convenient, safe and effective outside the OR.