Process for Adults vs. Children

Specialties CRNA

Published

Why is halothane used for children? And why is isoflurance often preferred for adults?

First of all... regarding why halothane for kids...non-pungency...better for inhaled induction. Most adults have an IV and will have an Iv induction then you intubate and hook them up to the iso. If you were to use iso for inhaled induction you would get breath holding ect ect because of its bad smell and pungency....

second... halothane is NOW used in very few places... I just got out of school and used it once at a childrens hospital. Sevoforane is now the agent of choice for inhaled inductions...

you might read the chapter discussing these agents in any of your texts...

I just finished up my first 2 months of my pediatric rotation. I used Halothane quite a bit and really liked it. As soon as the heart rate started to drop, the patient was deep enough and it was time to dial it back. It was great for mask cases like nasal lacrimal duct repair, or nasal probing where you would need to remove the mask for a couple of minutes, since it 's solubility will cause it to stay around a while. I was able to do a few inductions with Iso also. It worked really well on kids that had enough pre-med on board to be very cooperative. Just had to titrate it very slowly, but it worked nicely. I would not say that Iso is preferred with adults. However, I really like to use it with low flows.

Goose

Since Halothane has been removed from formulary I tend to use Sevo & Nitrous for inhalation induction. If the case is going to be long then I will switch to Iso once the child is alseep. Children seem to wake up smoother but some anesthesia providers don't agree with mixing volatile agents.

Wow, there are places still using Halothane? I was under the impression that they stopped making it last year. Personally, I'm a Desflurane girl myself. ;)

dont forget that although halothane was used for many years and was a good agent, it sensitizes the heart to catacholamines. if you give local with epi, you can get vtach vfib rather easily. this is one main reason it fell out of favor.

d

Specializes in Critical Care, Emergency.

usually with 'healthy' kids, the chance of using 1.5 mcg/kg of epi thru the case is relatively low.. aside from that, i prefer to not use halothane at all.. kids for me is sevo/iso.. des for the big people~

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