Sequential method for determining the impact of subdose etomidate on sevoflurane MAC during pediatric laparo-scopic surgery
ZHONG Ai-qun
HUANG Wei-wen
PENG Dan-dan
OU Jin-hui
WANG Min
Abstract：Objective To use a sequential method to determine the impact of subdose etomidate intravenous infu-sion on the end-expiratory alveolar concentration(MAC)of sevoflurane during inhalation anesthesia in pediatric patients undergoing laparoscopic surgery.Methods Seventy pediatric patients aged 2-12 undergoing elective laparoscopic sur-gery under general anesthesia were selected and randomly divided into the etomidate group(Group S,n=35)and the blank control group(Group C,n=35).Both groups received anesthesia induction with propofol 3 mg/kg and remifentanil 3 μg/kg(＞60 s).After intubation without muscle relaxants,patients in Group S received a subdose of etomidate 0.5 mg/kg as a loading dose followed by an infusion of 0.5 mg/(kg·h),while patients in Group C received a saline place-bo.Both groups were given an initial sevoflurane target concentration of 2.5％for anesthesia maintenance.After stabili-zing the sevoflurane MAC for 15 minutes,the surgical incision was made,and the presence of body movement reactions in the patients was observed.The sevoflurane concentration for the next patient was adjusted based on the principles of se-quential testing.Heart rate(HR),mean arterial pressure(MAP),and adverse reactions were recorded.Results There were no statistically significant differences in general information between the two groups(P＞0.05).The sevoflurane MAC was 1.54％in Group S and 2.06％in Group C,with a statistically significant difference between the groups(P＜0.05).There were statistically significant differences in HR and MAP before and after skin incision in both groups(P＜0.05).In Group S,one case of postoperative agitation occurred,and in Group C,three cases of postoperative agitation,as well as hypotension and bradycardia in four cases.Conclusion Subdose etomidate intravenous infusion can safely and effectively reduce the sevoflurane MAC in pediatric patients undergoing laparoscopic surgery,enhance the efficiency of in-halation anesthesia,and reduce the incidence of circulatory depression and postoperative agitation.
Keywords：etomidatelaparoscopic surgerysevoflurane MACanesthetic efficacy
Publication Date：2023-11-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 1425-1429 )