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Optimal end-tidal concentration of sevoflurane to test an ankle clonus in children

 Chul Ho Chang  ;  Seung Ho Choi  ;  Yon Hee Shim  ;  Ki-Young Lee  ;  Hwan-Mo Lee  ;  Yang-Sik Shin 
 SPINE, Vol.31(21) : 813-816, 2006 
Journal Title
Issue Date
Adolescent ; Anesthesia Recovery Period* ; Anesthesia, General/adverse effects ; Ankle*/physiology ; Child ; Child, Preschool ; Female ; Humans ; Inspiratory Capacity/drug effects ; Inspiratory Capacity/physiology ; Male ; Methyl Ethers/administration & dosage* ; Prospective Studies ; Reflex, Abnormal/drug effects* ; Reflex, Abnormal/physiology* ; Sevoflurane
spinal cord ; ankle clonus ; sevoflurane ; endtidal concentration ; children
STUDY DESIGN: A prospective randomized study on the end-tidal concentrations of sevoflurane at which ankle clonus existed.
SUMMARY OF BACKGROUND DATA: The ankle clonus reflex is a transient neurologic abnormality, which normally occurs in patients during emergence from general anesthesia.
OBJECTIVE: To determine the optimal end-tidal concentration of sevoflurane to test an ankle clonus in children during emergence from general anesthesia.
METHODS: We studied 30 children (aged 5-15 years). General anesthesia was induced with thiopental sodium. Anesthesia was maintained with sevoflurane, oxygen, and air. At completion of surgery, 3% volume of the end-tidal sevoflurane concentration was maintained for at least 10 minutes. Ankle clonus was checked at 1.0% to 0.1% volume of the end-tidal sevoflurane concentration with an interval of 0.05% volume.
RESULTS: Of children, 80% had bilateral ankle clonus, which was found most frequently when patients responded poorly to verbal commands. The median of the end-tidal sevoflurane concentration for a reactive ankle clonus was 0.45% volume (interquartile range 0.5% to 0.4% volume).
CONCLUSIONS: The ankle clonus should be tested at 0.45% volume of end-tidal sevoflurane concentration in children undergoing scoliosis surgery during emergence from the general anesthesia.
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1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학교실) > 1. Journal Papers
Yonsei Authors
Shin, Yang Sik(신양식)
Shim, Yon Hee(심연희) ORCID logo https://orcid.org/0000-0003-1921-3391
Lee, Ki Young(이기영) ORCID logo https://orcid.org/0000-0003-4893-3195
Lee, Hwan Mo(이환모) ORCID logo https://orcid.org/0000-0002-5405-3832
Chang, Chul Ho(장철호) ORCID logo https://orcid.org/0000-0001-5647-8298
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