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Canadian Journal of Anesthesia 47:193-194 (2000)
© Canadian Anesthesiologists' Society, 2000

Correspondence

Sevoflurane sedation

David Halpenny, MD FRCPC

Calgary, Alberta

To the Editor:

I would like to detail a method of sedation for reader comment and feedback. Volatile agents are not commonly used for sedation for a number of reasons which include difficulty of administration and patient intolerance. Some recent publications, however, have suggested that Sevoflurane might be used in this capacity.1,2

Nasal prongs with an entidal sampling tube (Salter Labs – REF 4707F) are attached to the common gas outlet of an anesthesia machine. The nasal prongs are placed on the patient in the usual manner, and then a standard oxygen mask (Airlife #00121) is also fitted over the patient and attached to the wall suction. The facemask now becomes the scavenging unit to minimize room contamination. Using flows of 2 litres of nitrous oxide and 1 litre of oxygen, sevoflurane can now be administrated at clinically useful concentrations and measured by the end tidal monitor.

Experience has shown me that after five to ten minutes, a stable level of light sedation can be achieved with typical dial settings of 2% - 3% yielding a sleepy yet easily aroused patient. This method works best with procedures where the analgesia has been provided by another modality (local, spinal, etc.) to avoid the necessity of higher concentrations and the associated "excitement" phase of inhalation anesthesia. Room contamination is minimal and this has been confirmed by sampling with a portable mass spectrometer (Marquette RAMS m-2000). Calculations suggest that the cost of sevoflurane used in this manner averages $15.00 per hour.

Reference

1 Philip JH, Myers TP, Philip BK, et al. Inhalation sedation/analgesia with sevoflurane (Letter). J Clin Anesth 1997; 9: 608–9.[Medline]

2 Savrski A, McClean R, Ikeando A, et al. Sevoflurane versus midazolam for conscious sedation in patients undergoing elective procedures: safety results. American Society of Anesthesia Abstracts, 1999.




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[Abstract] [Full Text] [PDF]

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