Investigation of the Optimum Time for Intravenous Access After Anesthesia Induction with Sevoflurane in Pediatric Patients Without Premedication.

Objective: Anesthesia induction is usually achieved with sevoflurane for pediatric patients without vascular access. The aim of this study was to investigate the optimum intravenous access time and to evaluate the corresponding bispectral index (BIS) value in pediatric patients after sevoflurane induction.

Method: This prospective study included 100 children enrolled between January 1, 2017 and January 1, 2018 at Istanbul Medeniyet University Goztepe Training and Research Hospital. Anesthesia was induced with 8% sevoflurane and oxygen. Measurements included mask adaptation time, time to loss of the ciliary reflex, time to recovery of regular breathing, and optimal timing of intravenous access time with the corresponding BIS values, as well as the time elapsed for the BIS value to fall below 60.

Results: The mean mask adaptation time was 27.8±28.4 s, time to loss of the ciliary reflex was 39.7±10.3 s, and time to reach regular respiration was 88.5±116.9 s, with mean BIS value of 80.4±16.9, 70.2±10.4, and 52.4±12.1, respectively. The mean time for BIS to fall below 60 was 72.54±24.41 s. The mean time required for the the iniation of optimal intravenous access was 104.92±36.45 s, with a mean BIS value of 30±10.1.

Conclusion: Following anesthesia induction with sevoflurane in children, the BIS value below 60 which is the upper limit for surgical anesthesia, was found to be insufficient for intravenous intervention. For pediatric patients undergoing sevoflurane induction it has been concluded that, the BIS value below 30 or an average waiting time of 104.9 s is ideal for initiation of optimal intravenous access.