Ideal Time for the Placement of Intravenous Catheter in Children Following the Induction of Anaesthesia With Sevoflurane in Nitrous Oxide and Oxygen Without Any Premedication

Background Children scheduled for surgical procedures who don't have a pre-placed or functional Intravenous Catheter (IVC) often undergo inhalational induction prior to attempting Intravenous Catheter Placement (IVCP). An optimum depth of anaesthesia is necessary to prevent adverse consequences of painful stimuli. Here, it becomes important to correlate the optimal time following induction with that of optimal depth of anaesthesia to carry out IVCP in children. We endeavoured to determine the ideal time for IVCP in un-premedicatedchildren following inhalational induction of anaesthesia. Methods Ours was a prospective, up-down sequential allocation, observer-blinded study conducted on 106 un-premedicated children, aged 1 to 10 years. The IVCP time was set at 3 minutes after the loss of eyelash reflex for the first child following induction with sevoflurane and nitrous oxide in oxygen using a single-step approach, and the time for cannulation was determined by using a step-up-down size of 15 seconds initially and 5 seconds later on. The time of IVCP was considered ideal if there was no patient movement or cough while attempting. Results The mean ideal time for cannulation after loss of eyelash reflex following inhalational induction was 56.75 seconds (53.58 - 59.89 seconds) in 50% patients and 73.77 seconds (69.67 - 77.88 seconds) in 95% patients with 95% confidence limits. Conclusion A waiting period of 1 min 22 seconds (82 seconds) after the loss of eyelash reflex in un-premedicated children facilitates smooth IVCP following sevoflurane induction in nitrous oxide and oxygen by the single-step approach.