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- W2007142679 abstract "L’induction inhalatoire est le mode d’induction le plus fréquemment utilisé en anesthésie pédiatrique. Le sévoflurane est l’agent anesthésique de choix dans cette circonstance. La prémédication par midazolam ou clonidine améliore la compliance de l’enfant à la procédure. L’utilisation de fortes concentrations de sévoflurane permet une perte de conscience rapide associée à une parfaite tolérance respiratoire et hémodynamique. L’administration conjointe de N2O augmente la vitesse d’action du sévoflurane. Cependant, la capacité du sévoflurane d’induire des manifestations épileptiformes, rattachée à l’administration de fortes concentrations, justifie de limiter la fraction inspirée à 6 % et de réduire le temps d’exposition à des fractions alvéolaires inférieures à 1,5 MAC. L’utilisation d’une assistance ventilatoire durant l’induction permet un monitorage fiable des gaz expirés ainsi qu’un maintien de la normocapnie. Les conditions d’intubation sous sévoflurane ne sont pas toujours optimales et justifient l’administration d’un complément anesthésique intraveineux. Inhalation of anaesthetic agents is commonly used for anaesthetic induction in children. Sevoflurane has become the gold standard for anaesthetic induction in that setting. Premedication by midazolam or clonidine facilitates the acceptance of facial mask. Inhalation of high concentrations of sevoflurane permits a rapid loss of consciousness with a good respiratory and haemodynamic tolerance. A mixture of nitrous oxide in oxygen speeds loss of consciousness. However, epileptogenic effects of sevoflurane have been documented further to the administration of thigh concentrations. Consequently, guidelines recommend to use sevoflurane concentrations <6 % for induction and to reduce time spent at alveolar concentrations >1.5 MAC during maintenance of anaesthesia. Pressure support ventilation during inhalation induction allows to maintain normocapnia and to monitor FeSevo. Adding intravenous adjuvants may improve tracheal quality of tracheal intubation." @default.
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- W2007142679 date "2009-12-01" @default.
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- W2007142679 title "Comment gérer une induction inhalatoire chez l’enfant ?" @default.
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- W2007142679 doi "https://doi.org/10.1016/j.pratan.2009.11.004" @default.
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