Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-78c5997874-4rdpn Total loading time: 0 Render date: 2024-11-12T22:14:57.523Z Has data issue: false hasContentIssue false

10 - Intravenous induction versus inhalation induction for general anaesthesia in paediatrics

Published online by Cambridge University Press:  13 August 2009

By
Teresa Hardcastle
Edited by
Brian Smith ,
Paul Rawling ,
Paul Wicker  and
Chris Jones
Brian Smith
Affiliation:
Edge Hill College of Higher Education, Liverpool
Paul Rawling
Affiliation:
Edge Hill College of Higher Education, Liverpool
Paul Wicker
Affiliation:
Edge Hill College of Higher Education, Liverpool
Chris Jones
Affiliation:
Edge Hill College of Higher Education, Liverpool
Get access

Summary

Key learning points

  • Preferred techniques

  • The use of premedication

  • Intravenous induction techniques

  • Induction agents used

  • Inhalational induction techniques

  • Inhalational agents used in anaesthesia of paediatric patients

The two methods for induction of general anaesthesia are intravenous and inhalational. Intravenous is more frequently used than inhalational induction in adults whereas in paediatric anaesthesia both intravenous and inhalational induction techniques are widely used.

Paediatric anaesthesia is a challenging speciality in itself. Children are not small adults. The spectrum of diseases they suffer from is different from adults and their responses to disease and injury may differ both physically and psychologically. The differences in the anatomy and physiology of neonates, infants and children have important consequences in many aspects of anaesthesia (Aitkenhead et al., 2003). According to Mellor (2004) the technical difficulties that are associated with small size together with the child's psychological and developmental understanding may prove more challenging for induction of anaesthesia in the child compared with the adult. The special demands of inducing anaesthesia in children necessitate the unique skills of the anaesthesia team. One of the many challenges for the anaesthesia team is to minimise distress for the child at induction of anaesthesia (Holm-Knudsen et al., 1998).

According to Messeri et al. (2004) the induction of anaesthesia for surgery is a stressful time for both child and family. Donnelly (2005) argues that a young child's emotional development is immature and that the presence of a parent or carer will provide reassurance to maintain the child's sense of security.

Type
Chapter
Information
Core Topics in Operating Department Practice
Anaesthesia and Critical Care
 , pp. 102 - 109
Publisher: Cambridge University Press
Print publication year: 2007

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Aguilera, I. M., Patel, D., Meakin, G. H. & Masterson, J. (2003). Perioperative anxiety and postoperative behavioural disturbances in children undergoing intravenous or inhalation induction of anaesthesia. Paediatric Anaesthesia, 13, 501–7.Google Scholar
Aitkenhead, A. R., Rowbotham, D. J. & Smith, G. (2003). Textbook of Anaesthesia, 4th edn. London: Churchill Livingstone.
Bagshaw, O. N. T. & Stack, C. G. (1999). A comparison of halothane and isoflurane for gaseous induction of anaesthesia in infants. Paediatric Anaesthesia, 9, 25–9.Google Scholar
BNF. (2005). Volatile Liquid Anaesthetics. Desflurane. Available at: http://bnf.org/bnf/bnf/50/noframes/6573.htm (Accessed 21 November 2005).
BNF for Children. (2005a). Ametop ®. Available at: http://www.bnfc.nhs.uk/bnfc/bnfc/current/40704.htm (Accessed 17 November 2005).
BNF for Children. (2005b). EMLA®. Available at: http://www.bnfc.nhs.uk/bnfc/bnfc/current/6693.htm?q=%22emla%22#_hit (Accessed 17 November 2005).
Bortone, L., Picetti, E. & Mergoni, M. (2002). Anaesthesia with sevoflurane in children: nitrous oxide does not increase postoperative nausea and vomiting. Paediatric Anaesthesia, 12, 775–9.Google Scholar
Christiansen, E. & Chambers, N. (2005). Case report. Induction of anaesthesia in a combative child; management and issues. Paediatric Anaesthesia, 15, 421–5.Google Scholar
Collins, P. (1999). Restraining children for painful procedures. Paediatric Nursing, 11(3), 15–16.Google Scholar
Donnelly, J. (2005). Care of children and adolescents. In Woodhead, K. & Wicker, P., eds., A Textbook of Perioperative Care. London: Elsevier Churchill Livingstone, pp. 267–83.
Dubois, M. C., Piat, V., Constant, I., Lamblin, O. & Murat, I. (1999). Comparison of three techniques for induction of anaesthesia with sevoflurane in children. Paediatric Anaesthesia, 9, 19–23.Google Scholar
Gwinutt, C. (2004). Lecture Notes On Clinical Anaesthesia, 2nd edn. London: Blackwell.
Holm-Knudsen, R., Carlin, P. & McKenzie, F. (1998). Distress at induction of anaesthesia in children. A survey of incidence, associated factors and recovery characteristics. Paediatric Anaesthesia, 8(5), 383–92.Google Scholar
Kandasamy, R. & Sivalingam, P. (2000). Use of sevoflurane in difficult airways. Acta Anaesthesiologica Scandinavica, 44, 627–9.Google Scholar
Kleiber, C. & Harper, D. C. (1999). Effects of distraction on children's pain and distress during medical procedures: a meta-analysis. Nursing Research, 48(1), 44–9.Google Scholar
Lerman, J. (2004). Inhalational anaesthetics. Paediatric Anaesthesia, 14, 380–3.Google Scholar
Lien, C. A., Hemmings, H. C., Belomont, M. R.et al. (1996). A comparison: the efficacy of sevoflurane-nitrous oxide or propofol-nitrous oxide for induction and maintenance of general anaesthesia. Journal of Clinical Anaesthesia, 8, 639–43.Google Scholar
McCaffrey, M. & Beebe, A. (1989). Pain: Clinical Manual for Nursing Practice. St Louis: Mosby.
Mellor, J. (2004). Induction of anaesthesia in paediatric patients. Update in Anaesthesia, 18(8), 1. Available at: http://www.nda.ox.ac.uk/wfsa/html/u18/u1808_01.htm#pharm (Accessed 21 November 2005).Google Scholar
Messeri, A., Caprilli, S. & Busoni, P. (2004). Anaesthesia induction in children: a psychological evaluation of the efficiency of parents' presence. Paediatric Anaesthesia, 14, 551–6.Google Scholar
Moore, J. K., Moore, E. W., Elliott, R. A.et al. (2003). Propofol and halothane versus sevoflurane in paediatric day-case surgery: induction and recovery characteristics. British Journal of Anaesthesia, 90(4), 461–6.Google Scholar
Moore, N. (1998). Total Intravenous Anaesthesia (TIVA) in paediatrics: advantages and disadvantages. Paediatric Anaesthesia, 8(3), 189–94.Google Scholar
Murat, I. (2002). Editorial. Is there a place for desflurane in paediatric anaesthesia?Paediatric Anaesthesia, 12, 663–4.Google Scholar
Oakley, M. & Limborgh, M. (2005). Care of the patient undergoing anaesthesia. In K. Woodhead & P. Wicker, eds., A Textbook of Perioperative Care. London: Elsevier Churchill Livingstone, pp. 147–60.
Palermo, T. M., Tripi, P. A. & Burgess, E. (2000). Parental presence during anaesthesia induction for outpatient surgery of the infant. Paediatric Anaesthesia, 10, 487–91.Google Scholar
Przybylo, H. J., Tarbell, S. E. & Stevenson, G. W. (2005). Mask fear in children presenting for anaesthesia: aversion, phobia or both?Paediatric Anaesthesia, 15(5), 336–70.Google Scholar
Schwartz, D., Connelly, N. R., Gutta, S., Freeman, K. & Gibson, C. (2004). Early intravenous cannulation in children during sevoflurane induction. Paediatric Anaesthesia, 14: 820–4.Google Scholar
Smalley, A. (1999). Needle phobia. Paediatric Nursing, 11(2), 17–20.Google Scholar
Torrance, C. & Serginson, E. (1997). Surgical Nursing. London: Elsevier Science.
Viitanen, H., Baer, G. & Annila, P. (2000). Recovery characteristics of sevoflurane or halothane for day-case anesthesia in children aged 1–3 years. Acta Anaesthesiologica Scandinavica, 44, 101–6.Google Scholar
Wood, C. (2002). Introducing a protocol for procedural pain. Paediatric Nursing, 14(8), 30–3.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×