Sevoflurane Consumption During Inhalational Induction in Children: A Randomized Comparison of Minute Ventilation-Based Techniques With Standard Fixed Fresh Gas Flow Technique.

This study was done to ascertain the optimum fresh gas flow (FGF) offering the best balance between rapid induction and minimal waste in pediatric patients. Forty-five children (weighing 10-20 kg) undergoing elective procedures under general anesthesia were randomly assigned into 3 groups: 0.5 minute ventilation (MV), MV, and S (FGF = 6 L/min). After priming the pediatric closed circuit, anesthesia was induced using a face mask with 8% sevoflurane in 100% oxygen (Draeger Primus Vista 120 anesthesia machine) at FGF-determined MV per group allocation. After loss of eyelash reflex (time 1 [T1]), intravenous cannulation (T2) and laryngeal mask airway (LMA) placement (T3) were done. Total sevoflurane consumed during induction (measured using logbook function) was the primary outcome. The cost of sevoflurane, any reflex movement, tachycardia (heart rate change > 20%), or additional propofol boluses required were also recorded. Sevoflurane consumption (3.8 vs 5.8 vs 9.2 mL) and cost of sevoflurane (104.2 vs 199.4 vs 312.8 rupees) were lowest in group 0.5 MV (P < .001). There was no difference in hemodynamic parameters, movement on cannulation/LMA insertion, and rescue propofol boluses required. For pediatric sevoflurane induction, half the MV-based FGF provided similar anesthetic conditions for LMA insertion with minimum sevoflurane consumption.