Comparison of haemodynamic changes induced by sevoflurane and halothane in paediatric patients

Abstract

Comparison of haemodynamic changes induced by sevoflurane and halothane in paediatric patientsSevoflurane is used in paediatric anaesthesia 1,2 because of its small blood-gas partition coefficient (0.63), 3 which enables rapid induction of, and rapid emergence from anaesthesia. Paediatric patients have a relatively high minimum alveolar concentration (MAC) of volatile anaesthetics that may cause marked haemodynamic depression, especially in neonates and infants. 4-7 In mongrel dogs, sevoflurane decreases cardiac output (CO) and mean blood pressure (mBP) without change in the heart rate (HR). 8 The MAC of sevoflurane in children is much higher (2.49%) 2,9 than that in adults (1.71-2.05%). t~191 However, there are no reports of haemodynamic effects of sevoflurane in paediatric patients receiving high concentrations of sevoflurane. The purpose of this study was to compare the haemodynamic effects of sevoflurane and halothane in paediatric patients by using impedance cardiometry, a noninvasive method to measure CO and stroke volume (SV). MethodsAfter approval by the Ethics Committee of Sapporo Medical University, agreement was obtained from the parents of patients, to whom this study was fully explained. The investigation was carried out in 38 patients (from one to six years old) of ASA class I, who were to undergo CAN J ANAESTH 1995 / 42:7 / pp 603-7

Hemodynamic changes in children with Down syndrome during and following inhalation induction of anesthesia with sevoflurane

“…At one to two minimum alveolar concentration (MAC) sevoflurane, HR was maintained or increased in infants and children who received no atropine, although SBP was depressed 20% to 25% from awake values [17][18][19]. Data from the present study similarly found that children without Down syndrome experienced a slight though nonsignificant increase in HR from baseline, yet a significant decrease in MAP during sevoflurane use.…”

Sevoflurane in Paediatric Anaesthesia

“…[33,[42][43][44][45]49] The decreases were smaller than with desflurane, [51] similar to those with isoflurane [45] and generally similar to [49] or significantly lower [44] than with halothane. Changes in blood pressure and the incidence of hypotension (≥30% decrease in systolic blood pressure) were inversely related to age (the study included neonates aged ≤30 days and children aged 0.5 to 12 years).…”

“…[1] In 38 children (aged 1 to 6 years), equipotent doses of the 2 agents (with 100% oxygen) caused a significant reduction in stroke volume index but only slight nonsignificant decreases in cardiac index. [43] Cardiac index significantly decreased from awake values in 15 halothane-but not 15 sevoflurane-treated infants (mean age about 6 months) receiving equipotent doses of the drugs with N 2 O 50% (p < 0.05 for halothane vs sevoflurane also). [49] Halothane had a significantly greater depressant effect on most indices of contractility than sevoflurane in this [49] and another trial in 20 children.…”

“…[33,[41][42][43][44][45][46][47][48] In 2 studies [41,43] these increases were significantly (p < 0.05) greater than those seen with halothane, but in another [44] the difference was not significant. Results of a study conducted in 30 infants (mean age about 6 months) indicate that sevoflurane (1 to 1.5 MAC), unlike halothane, had no significant effect on heart rate versus awake measurements; halothane-induced decreases in this parameter were significant versus sevoflurane values.…”

Comparison of Sevoflurane With Halothane for Endotracheal Intubation in Paediatric Patients

“…Friesen R H et al (1982), 13 Epstein R H et al (1995), 14 Sarner J B et al (1995), 11 Shin Kawana et al (1995), 15 Black A et al (1996), 7 Brien K O et al (1998), 5 and H Vitanen (1999) 16 have studied mean arterial pressure during induction and after intubation under Sevoflurane and Halothane anaesthesia. In the present study, in group H, mean systolic blood pressure and mean arterial pressure decreased during intubation by 10 mm of Hg and increased after intubation.…”