Evaluation of Target-Controlled Inhalational Anesthesia in Pediatrics Using the Newly Introduced Zeus Anesthesia Workstation: A Prospective Clinical Study
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- Category: Vol. 77, June 2009
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Evaluation of Target-Controlled Inhalational Anesthesia in Pediatrics Using the Newly Introduced Zeus Anesthesia Workstation: A Prospective Clinical Study,MAGDA S. AZER
Abstract
Background: The optimal inhalational induction should provide titration of inhaled anesthetics to imply a fast and reliable alteration without overshooting the targeted inhaled agent concentration and involves a stable desired drug level. The recent option of target-controlled inhalation anesthesia was made possible by the introduction of Zeus anesthesia workstation. The aim of this study was to evaluate the target-controlled inhalational anesthesia in pediatrics using the Zeus anesthesia machine in comparison to the classic technique with the conventional anesthesia machine using sevoflurane.
Methods: In this prospective, controlled, clinical study, we randomized 40 children undergoing elective oncological surgery under general anesthesia into 2 equal groups to receive either target-controlled inhalational induction with sevoflurane through Zeus anesthesia machine [Target-controlled group (TC)], or to be induced classically with inhalation of sevoflu-rane through Fabius-CE conventional anesthesia machine (control group). Time to loss of conscious, wash in, washout times, time to target ETsevo and emergence time were recorded. Number of adjustments to reach the target sevoflurane con-centration and overshooting was also recorded.
Results: Mean time to attain and maintain target concen-tration (time to target TT) was significantly shorter in the target controlled group (TC 104±24.6 sec Vs control 210± 19.8 sec). A significantly longer emergence time was obtained in the control group (16.1±2.4min) versus (7.8±2.6min) in TC group. In addition number of adjustments to target ETsevo was higher in control group (7±1.5 in control group Vs 1±0.5 in TC group). Overshooting to a mean ETsevo of 4.9±0.1% occurred in the control group after 3 min of induction, whereas no overshooting occurred in the TC group. Mean wash in time as well as mean time to loss of conscious (TLOC) did not differ significantly in either group.
Conclusion: The target controlled inhalational anesthesia using the auto-control mode of the Zeus® apparatus allowed a very fast and reliable induction of sevoflurane in pediatrics with no overshoot. It also allowed minimal or no anesthetist intervention in reaching the target end-tidal sevoflurane concentration. Reduced emergence time as a result of very rapid washout times was also remarkable compared to con-ventional anesthesia machine.