COMPARATIVE STUDY BETWEEN SEVOFLURANE AND HALOTHANE IN EMERGENCY SURGERY IN PEDIATRICS

Abstract

Halothane has been used for pediatric anesthesia for many years although it has some disadvantages like myocardial depression, dysrhythmias, significant degree of metabolism and the rare but serious complication of hepatitis. So there is a need for a safer inhalational anesthetic more suitable for children. Sevoflurane, a fluorinated methyl ether, shows non-flammability, lack of arrhythmogenicity, lack of neuronal excitation relative cardiovascular stability, minimal effects on cerebral blood flow at low concentration and lack of renal and hepatic toxicity. In addition to these characteristics, sevoflurane exhibits a low blood solubility with a blood/gas partition coefficient of 0.6-0.69. It has a pleasant, non-irritating odour that makes it more acceptable to children. These qualities provide rapid and smooth inhalation induction of and rapid recovery from sevoflurane anesthesia. Approximately 3% of sevoflurane is metabolized with the remainder excreted unchanged by the lungs. Primary products of sevoflurane metabolism include inorganic fluoride and hexafluoroisopropanol. Also sevoflurane is degraded by soda lime to compound A which can cause renal toxicity in animals at high concentration, but up till now, there is no evidence of renal toxicity in humans from inorganic fluoride or compound A.