Comparison of mixture of sevoflurane in 50% N2O/O2 with sevoflurane in 100% O2 in neonates undergoing TEF/EA repair

Background: The efficient recognition and prompt management of illness in the neonatal period may be lifesaving. Perioperative airway management in the neonate undergoing tracheoesophageal fistula (TEF) repair could be a challenge for anesthesiologist. We need to place the tip of the endotracheal tube (ETT) below the fistula but above the carina to ensure airway protection, adequate ventilation and avoid gastric dilatation during positive pressure ventilation (PPV). Materials and Methods: Thirty neonates undergoing TEF repair were taken for the study. Neonates were randomised into two groups of 15 each. In group-I induction was done with 8% sevoflurane in 50% N2O and 50% O2 and in group-II with 8% sevoflurane in 100% oxygen. Results: The mean induction time in group-I was 32.91 sec. which was significantly less than that in group-II 54.60. The mean intubation time in group-I was 112.35 sec. which was significantly less than that in group-II 134.53. In both cases P-value is highly significant. In group I mean SpO2 value was 96.18, which is slightly less than in group-II 98.22. Here the P-value is slightly significant. In both the groups there was no difference in heart rate. Conclusion:Thus, induction of anaesthesia with a mixture of 8% sevoflurane in 50% N2O and 50% O2 was faster, smoother with only slightly significant decrease in SpO2 which was acceptable during induction and with minimal side effects as compared to group-II.

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