• George D Politis, Michael J Frankland, Robert L James, Jacland F ReVille, Michael P Rieker, and Betty C Petree.
• Department of Anesthesiology, University of Virginia Health System, PO Box 800710, Charlottesville, VA 22908, USA. gdp8a@virginia.edu
• Anesth. Analg. 2002 Sep 1;95(3):615-20, table of contents.

UnlabelledBetter definition of end points required to achieve successful tracheal intubation after induction with sevoflurane could improve patient care. The authors therefore designed a study that could determine, with meaningful confidence intervals, the time required to successfully intubate 80% of children by using 8% inspired sevoflurane and no muscle relaxant. We hypothesized that the time required could vary by age or body mass index. One-hundred fifty-three ASA physical status I or II patients received induction with 8% sevoflurane in 60% nitrous oxide with discontinuation of nitrous oxide 1 min after the start of the induction. The time until laryngoscopy remained close to the time required to achieve 80% successful intubation by varying induction time according to the success rate in each group of five patients. A probit model of induction time and age found that both were predictive of successful intubation (P values of 0.006 and 0.02, respectively). The induction times needed to achieve 80% successful intubation were 137 s (95% confidence interval, 94.6-159 s) and 187 s (153-230 s) for ages 1-4 yr and 4-8 yr, respectively. The persistence of spontaneous ventilation at the time of laryngoscopy, despite attempts to control ventilation, was associated with poor intubation conditions (P < 0.001).ImplicationsTo successfully intubate 80% of children by using sevoflurane and no muscle relaxant, induction times of 137 and 187 s were needed in children of 1-4 yr and 4-8 yr, respectively.

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