BACKGROUNDS: In this study, we assessed nasotracheal intubation conditions following an inhalation induction using 8% sevoflurane and nitrous oxide with fentanyl and evaluated the effect of 0.1 mg/kg dexamethasone on postoperative nausea and vomiting (PONV) in pediatric ambulatory patients.

METHODS: Forty-two pediatric patients requiring nasotracheal intubation were scheduled for ambulatory procedures. Anesthesia was induced with sevoflurane 8% in a nitrous oxide and oxygen mixture, and after an end-expiratory concentration of sevoflurane of at least 4.5% had been reached, the trachea was intubated. Intubating conditions were graded as excellent, good, poor or impossible according to Good Clinical Research Practice criteria, and the incidence of adverse events during induction were also noted. Patients were randomly allocated to receive normal saline (control group, n = 20) or dexamethasone 0.1 mg/kg (dexamethasone group, n= 22) after the induction of anesthesia.

RESULTS: Nasotracheal intubation was accomplished successfully in 100% of the patients and clinically acceptable intubating conditions were obtained in 38 patients (25 excellent and 13 good). There were no significant differences between the two groups in age, sex, and operation time. In the 0 to 6 hour postoperative period, the incidences of PONV were 15% and 9% in the control and dexamethasone groups respectively, but this was not significantly different.

CONCLUSIONS: Induction with sevoflurane in nitrous oxide and oxygen provided ideal conditions for nasotracheal intubation. Intraoperative dexamethasone did not significantly reduce PONV after inhalation induction and maintenance with sevoflurane during the first 6 hour postoperative period in pediatric patients.