Minimum alveolar concentration of sevoflurane for tracheal extubation in children

Background: One advantage of tracheal extubation during deep anaesthesia is that respiratory complications are reduced. Sevoflurane is a suitable anaesthetic agent for children. This study was conducted to determine the minimum alveolar concentration of sevoflurane required to prevent cough or movement during and after tracheal extubation (MAC(extubation)) Methods: We studied 30 nonpremedicated children, aged 2-10 yr, undergoing plastic surgery. They were allocated randomly to five groups (end-tidal sevoflurane concentrations: 2.0, 2.5, 3.0, 3.5, 4.0%). After surgery, 60% nitrous oxide was discontinued and the target concentration of sevoflurane was maintained for at least 10 min in 100% oxygen, then the trachea was extubated to determine MAC(extubation). Logistic regression was used to estimate MAC(extubation) of sevoflurane. Results: MAC(extubation) was 2.3 (0.2; standard error)% (95% confidence limits: 1.2% and 2.7%). Conclusions: Tracheal extubation in 50% of anaesthetized children age 2-10 yr may be accomplished without coughing or moving at 2.3% end-tidal concentration of sevoflurane.