Intravenous Access Time in Pediatric Patients
Intravenous Access Time in Pediatric Patients
In pediatric patients with no vascular access, anesthesia induction is usually achieved with
 sevoflurane. The aim of investigators to evaluate the optimum intravenous access time and the
 corresponding bispectral index (BIS) value in pediatric surgery under sevoflurane anesthesia.
Patients undergoing anesthesia induction must have at least one vascular access opened for
 administration of intravenous drugs and fluid. In pediatric patients, fear of needles and
 anxiety about pain can cause discomfort. For this reason, inhalational anesthetics are
 commonly used for anesthesia induction in children. An ideal inhalational anesthetic agent
 should have a smooth and fast onset, little irritation to the respiratory tract, and no
 undesirable side effects. Sevoflurane meets almost all these criteria, so it is commonly used
 for anesthesia induction in pediatric patients.

 Studies related to the induction of anesthesia with sevoflurane have mostly focused on the
 ease of LMA insertion, the recovery characteristics, the hemodynamic variabilities,
 comparison of high and low initial sevoflurane concentrations, and cost comparisons between
 fixed 8% versus incremental techniques. However, after loss of consciousness, children
 subjected to early intravenous cannulation during sevoflurane induction can display movement,
 breath holding, coughing, and even laryngospasm. Only limited data are available in the
 literature regarding intravenous access time at anesthesia induction. The aim of the present
 study was to evaluate the bispectral index (BIS) values and sevoflurane concentrations during
 induction of anesthesia and to determine the optimum intravenous access time in pediatric
 patients.
Inclusion Criteria:

 -  American Society of Anesthesiologists (ASA) physical status I or II

 -  Age between 2 months to 11 years

 -  Patients scheduled for day case surgery (including inguinoscrotal hernia or hydrocele,
 undescended testis, hypospadias, or routine circumcision)

 -  Diagnostic procedures (e.g., cystoscopy) or external ventricular drainage.

 Exclusion Criteria:

 -  Obesity

 -  Malnutrition

 -  Gastroesophageal reflux disease

 -  Allergy

 -  Sensitivity to volatile anesthetics

 -  Procedures lasting more than two hours.