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Excerpt
We have noticed that inhalational induction with sevoflurane 'switches off' airway reflexes almost as effectively as intravenous (i.v.) induction with propofol - it is almost like 'propofol in a vaporizer'. This occurs at relatively light levels of anaesthesia, and is sufficient to allow insertion of a laryngeal mask airway, direct laryngoscopy and sometimes even endotracheal intubation. We now use this effect to our advantage when anaesthetizing those with potentially difficult airways. Following induction with sevoflurane in oxygen, direct laryngoscopy is gently performed and an assessment of intubation difficulty rapidly made. Light anaesthesia, preservation of spontaneous ventilation and use of an agent associated with rapid emergence, all help to secure the 'escape route' back to consciousness. We feel that, in comparative terms, sevoflurane is to halothane as propofol is to thiopentone.
