A six year old child is posted for elective urology surgery under general anesthesia. He refuses to allow the anaesthesiologist an I.V. access. The best inhalational agent of choice for induction of anesthesia is:
**Core Concept**
The question requires knowledge of inhalational anesthetics and their properties, particularly in pediatric patients. The ideal inhalational agent for induction of anesthesia in a child who refuses IV access should have a rapid onset of action, minimal irritation to the respiratory tract, and a pleasant odor to reduce anxiety.
**Why the Correct Answer is Right**
Sevoflurane is the best inhalational agent of choice for induction of anesthesia in this scenario. It has a rapid onset of action, with a minimum alveolar concentration (MAC) of 2%, allowing for quick induction. Sevoflurane is also less irritating to the respiratory tract compared to other inhalational agents like desflurane and isoflurane. Additionally, sevoflurane has a sweet, non-irritating odor, which can help reduce anxiety in pediatric patients.
**Why Each Wrong Option is Incorrect**
**Option A:** Halothane is an older inhalational agent that was once commonly used for induction in pediatric patients. However, it has been largely replaced by sevoflurane due to its potential for hepatotoxicity and the availability of safer alternatives.
**Option B:** Desflurane has a pungent odor and can cause airway irritation, making it less suitable for induction in pediatric patients.
**Option C:** Isoflurane can also cause respiratory tract irritation and is not as pleasant-smelling as sevoflurane, making it a less ideal choice for induction in children.
**Clinical Pearl / High-Yield Fact**
When selecting an inhalational agent for induction in pediatric patients, consider the agent's pungency, respiratory tract irritation potential, and odor. Sevoflurane is often the preferred choice due to its rapid onset, minimal irritation, and pleasant odor.
**Correct Answer:** C. Sevoflurane