This is the last paediatric one for a while. However, it’s probably the most relevant one so plenty of questions. Miller has a nice chapter on this (8e Ch93). Given that yesterday’s post was so short, you get some bonus statements today!
When sevoflurane first came out it was heinously expensive compared to halothane and so we weren’t allowed to use it very often at the parsimonious unnamed children’s hospital in Victoria. Halothane inductions took a while (why? and why particularly with spontaneous ventilation?) and the advice was “when you think they are anaesthetised, wait another couple of minutes” before instrumenting the airway. We could use sevoflurane for quick inductions (to save money) but not for the case. Halothane also took a lot longer to wear off than sevoflurane (why?), so the Recovery Room was a quiet, full place. When sevoflurane came into routine use it was often called “screamothane” by the Recovery staff. Why was that?
T/F MAC of sevoflurane for neonates is about 3.3%
T/F the incidence of emergence excitement and agitation is higher with sevoflurance than halothane
T/F the induction dose of propofol should be reduced in infants compared to older children
T/F TCI propofol should not be used in children because of the risk of propofol infusion syndrome
T/F the required dose of suxamethonium in infants is twice that of older children
Enough of the easy ones, how about these:
T/F ketamine as a sole anaesthetic agent preserves the gag reflex
T/F rocuronium can be administered intramuscularly in children
T/F sugammadex may not be administered to children under 12
And finally, for the real experts:
T/F clearance of alfentanil is reduced in children compared to adults
T/F newborns have a slower clearance of morphine than older neonates