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COMPARISON OF PATIENT CONTROLLED SEVOFLURANE INDUCTION WITH SEVOFLURANE VITAL CAPACITY INDUCTION IN OUTPATIENTS UNDERGOING ARTHROSCOPY

Department of Anesthesia, Toronto Western Hospital, University Health Network, University of Toronto, 399 Bathurst St., Toronto, Ontario, Canada, M5T 2S8

INTRODUCTION

The technique of Patient Controlled Induction (PCI) using sevoflurane (sevo) inhalation is popular. Although this technique has been considered as an easy and effective method to be used in adults as well as cooperative children, few studies have been performed to compare it with other sevo induction techniques. We designed this clinical study to compare PCI with the most commonly used sevo induction technique, Vital Capacity Induction (VCI).¹

METHODS

Following the approval of Research Ethics Board, 118 outpatients undergoing knee arthroscopy were randomly assigned to receive either PCI or VCI sevo induction followed by a laryngeal mask airway (LMA) insertion and sevo maintenance. The circuit was not primed and the patients in PCI group were asked to hold the facemask themselves and breathe normally with sevo 8% dial marker concentration in oxygen at a flow rate of 4 L/min. Patients in VCI group were asked to do vital capacity breaths with sevo concentration of 8% but at a flow rate of 8 L/min. The LMA was inserted as soon as the patient's jaw was relaxed. Times from induction to LMA insertion were recorded. The airway condition for LMA insertion was rated by the anesthesiologist. In addition, the consumption of sevo for LMA insertion was calculated. Patients' vitals were monitored at 1-min intervals until 10 min after LMA insertion.

RESULTS

The demographic data were comparable. There were no differences found with respect to induction time, induction side effects, airway condition, MAP, HR, PaO2 as well as patient's overall satisfaction. However, the sevo usage in the VCI group was significantly higher than that in the PCI group.

Time to LMA insertion (min) Coughing (%) Breath holding (%) Laryngeal spasm (%) Movement (%) Sevo usage (ml) PCI 3.4±1 0 16 6 15 4.43±1 VCI 3.3±1 2 8 4 20 8.00±3 *

CONCLUSION

PCI was comparable to VCI in sevo induction with respect to the speed and quality. The amount of sevo consumed for the induction was significantly less in PCI technique than in VCI technique.

REFERENCE

1 Philip BK, Lombard LL, Roaf ER. Comparison of vital capacity induction with Sevoflurane to intravenous induction with Propofol for Adult Ambulatory Anesthesia. Anesth Analg 1999;89:623–7[Abstract/Free Full Text]

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