A. Beskow et al., INTRAVENOUS INDUCTION OF GENERAL-ANESTHESIA WITH ELTANOLONE IN CHILDREN 6-15 YEARS OF AGE, Acta anaesthesiologica Scandinavica, 41(2), 1997, pp. 242-247
Background: Eltanolone is a short-acting intravenous anaesthetic, form
ulated as an oil-water emulsion. The aim of the present study was to e
stimate the anaesthetic dose (ED(50)) for induction in children 6-10 a
nd 11-15 years of age and to collect safety data. Methods: Forty-nine
unpremedicated children, all ASA I or II, divided in one pilot-study g
roup, with 5 children 6-15 years and two main study groups, 6-10 and 1
1-15 years of age, were studied. The first patient in each study group
was given 0.86 mg/kg of eltanolone iv over 20 s. Fifty s after inject
ion the chin was gently lifted to 'the sniffing position' and the anae
sthesia mask was placed over the face. Induction was considered satisf
actory if there was no gross movement, coughing or response to verbal
command during the following 15 s. The dose selected for the next pati
ent was based on the observed response: if induction was not classifie
d as satisfactory the dose was increased by a factor of 20%, otherwise
it was decreased by the same factor. ED(50) was estimated as describe
d by Dixon and Massey. Results: In children 6-10 years of age ED(50) w
as 0.68 (0.49-0.92; 95% confidence limits) mg/kg and in children 11-15
years of age 0.53 (0.41-0.68) mg/kg. No child showed sign of pain on
injection. One patient developed urticaria and 15 patients had transie
nt rash after induction. Two patients (both responders receiving 0.86
and 0.40 mg/kg respectively) had apnoea lasting more than 15 s. Involu
ntary movements occurred in one patient. Conclusion: The ED(50) of elt
anolone for induction of anaesthesia in unpremedicated children 6-10 y
ears of age was 0.68 mg/kg and in children 11-15 years of age 0.53 mg/
kg. The findings suggest that an induction dose for children 6-15 year
s of age of about 1 mg/kg would be adequate in most cases. No serious
adverse events were recorded. However, the drug has subsequently been
withdrawn from further investigation due to an unacceptable incidence
of rash and urticaria. (C) Acta Anaesthesiologica Scandinavica 41 (199
7).