Dose N2O Cause Paradoxical Reaction in Response to Noxious Stimulants During Inhalation Induction of Anesthesia in Pediatrics?

Document Type : Original Article(s)

Authors

1 Associated Professor, Department of Anesthesia and Critical Care, School of Medicine, Isfahan University of Medical Sciences, Isfahan

2 Anesthesiatist, Gharazi Hospital, Malyer

Abstract

Background: Bispectral Index is one of the qualitative methods of measuring of sedation and depth of anesthesia. In a few studies appeared a paradoxical effect of N2O on BIS in adults. In this study, the paradoxical effects of N2O during inhalation induction of anesthesia in pediatrics by halothane and isoflorane were evaluated. Methods: In a clinical trial study, eighty 1-6 year old age, ASA I and II pediatrics who candidate for abdominal and extremities elective surgeries were evaluated in 4 groups (Halothane, Isoflorane, Halothane plus N2O and Isoflorane plus N2O). Anesthesia was induced by gradual increase of vapor gas in 100% of O2 in groups 1 and 2 and in 50% of N2O in O2 in groups 3 and 4. BIS and other variables were measured before and after of laryngoscopy and surgical incision. Findings: The mean of percent changes of BIS after the laryngoscopy in comparison to pre-laryngoscopy in 4 groups were: 0.15 ± 13.95, 16.57 ± 19.49, 4.90 ± 42.68, and 31.22 ± 28.19 (P = 0.287). The pre and after surgical incision BIS were: -3.88±23.30, 19.36 ± 9.17, 16.73 ± 2.33, and 7.75 ± 13.3 (P = 0.121). Conclusion: This study could not confirm appearance of paradoxical effects of N2O on BIS during inhalation induction of anesthesia in pediatrics. Key words: BIS, N2O, Pediatric, Inhalation, Induction.