In a child, the anaesthetic of choice is –
**Core Concept**
Sevoflurane is a commonly used inhalational anaesthetic agent in children due to its favourable pharmacological properties. It has a low pungency, making it suitable for inhalational induction in children, and it is metabolized by the liver to a lesser extent compared to other inhalational agents.
**Why the Correct Answer is Right**
Sevoflurane is the preferred choice for anaesthesia in children because it allows for smooth and rapid induction of anaesthesia. The low pungency of sevoflurane reduces the incidence of coughing and laryngospasm, making it ideal for inhalational induction in paediatric patients. Additionally, sevoflurane has a high blood-gas partition coefficient, which enables rapid equilibration of the drug between the blood and the brain, resulting in quick onset of anaesthesia.
**Why Each Wrong Option is Incorrect**
**Option A:** Enflurane is an older inhalational anaesthetic agent with a higher risk of seizures and is not the preferred choice for children due to its potential for neurotoxicity.
**Option B:** Isoflurane is a widely used inhalational agent, but it has a higher pungency compared to sevoflurane, making it less suitable for inhalational induction in children.
**Option D:** Halothane is an older inhalational anaesthetic agent that has been largely replaced by sevoflurane due to its higher risk of hepatotoxicity and potential for sensitization of the myocardium to catecholamines.
**Clinical Pearl / High-Yield Fact**
Sevoflurane is known for its "sweet" smell and is often used for inhalational induction in children. However, it is essential to note that sevoflurane can cause a decrease in blood pressure and cardiac output, especially in paediatric patients, and should be used cautiously in patients with cardiovascular disease.
**✓ Correct Answer: C. Sevoflurane**