Minimum alveolar concentration of sevoflurane for tracheal extubation in children.

Abstract

One advantage of tracheal extubation during deep anaesthesia is that respiratory complications are reduced. Sevoflurane is a suitable anaesthetic agent for children. This study was conducted to determine the minimum alveolar concentration of sevoflurane required to prevent cough or movement during and after tracheal extubation (MACextubation). We studied 30 nonpremedicated children, aged 2-10 yr, undergoing plastic surgery. They were allocated randomly to five groups (end-tidal sevoflurane concentrations: 2.0, 2.5, 3.0, 3.5, 4.0%). After surgery, 60% nitrous oxide was discontinued and the target concentration of sevoflurane was maintained for at least 10 min in 100% oxygen, then the trachea was extubated to determine MACextubation. Logistic regression was used to estimate MACextubation of sevoflurane. MACextubation was 2.3 (0.2; standard error)% (95% confidence limits: 1.2% and 2.7%). Tracheal extubation in 50% of anaesthetized children age 2-10 yr may be accomplished without coughing or moving at 2.3% end-tidal concentration of sevoflurane.