Intravenous literature: Joshi, A., Lee, S. and Pawar, D. (2012) An optimum time for intravenous cannulation after induction with sevoflurane in children. Paediatric Anaesthesia. Feb 6. [Epub ahead of print].
Background: It is a common practice to perform inhalational induction with sevoflurane followed by intravenous cannulation in children. However, there is little information regarding the time at which the intravenous cannulation can be attempted safely after sevoflurane induction.
Aim: To determine the optimal time for safe intravenous cannulation in children induced with sevoflurane.
Methods: Pediatric patients aged 4-10â€ƒyears receiving sevoflurane inhalational induction for elective cases were recruited. General anesthesia was induced with sevoflurane and oxygen via mask, then intravenous cannulation was attempted. The time for intravenous cannulation was determined by the use of up-and-down method using 30â€ƒs as a step size. Intravenous cannulation without any movement, coughing, or laryngospasm was considered successful. The up-and-down sequences were analyzed by the probit test.
Results: The time for effective intravenous cannulation in 50% patients was 1.90â€ƒmin (95% confidence limits, 1.24-2.41â€ƒmin). The time for effective cannulation in 95% of patient population was 3.32â€ƒmin (95% confidence limits, 2.68-6.77â€ƒmin).
Conclusion: We recommend an optimal time of 3.5â€ƒmin for attempting intravenous cannulation after the loss of eyelash reflex with sevoflurane induction.