title: Alfentanil infusion for sedation in infants and small children during cardiac catheterization.
abstract: We have analyzed several sedation techniques for paediatric cardiac catheterization which offer stable conditions for a few hours investigation, and maintain spontaneous breathing. In the present study, after premedication with oral flunitrazepam 0.1 mg.kg-1, 14 children aged 1-17 mo were sedated with an individually titrated alfentanil infusion. Every patient was sedated to a level which produced no reaction to pain or any discomfort. The induction dose and the maintenance requirement of alfentanil were 24 +/- 8 micrograms.kg-1 and 32 +/- 8 micrograms.kg-1.hr-1 (mean +/- SD), respectively. These doses were less in cyanotic than in acyanotic patients: 21 +/- 6 vs 28 +/- 8 micrograms.kg-1 and 29 +/- 10 vs 34 +/- 3 micrograms.kg-1.hr-1, respectively (P less than 0.05). The mean plasma concentration of alfentanil during maintenance of sedation was 79 +/- 23 ng.ml-1. Ventilation of two children was assisted for a short time after an incremental bolus of alfentanil. It is concluded that an alfentanil infusion technique with close monitoring of breathing is a practical sedation method for paediatric cardiac catheterization.
authors.affiliation: Department of Anaesthesia, Children's Hospital, University of Helsinki, Finland.
authors.forename: P
authors.initials: P
authors.lastname: Rautiainen
mesh_terms: D015760:Alfentanil / Q000008:administration & dosage / Q000097:blood; D000762:Anesthesia Recovery Period; D000771:Anesthesia, Intravenous / Q000379:methods; D001794:Blood Pressure / Q000187:drug effects; D002245:Carbon Dioxide / Q000097:blood; D006328:Cardiac Catheterization; D003243:Consciousness / Q000187:drug effects; D003490:Cyanosis / Q000503:physiopathology; D004071:Digitalis Glycosides / Q000627:therapeutic use; D004305:Dose-Response Relationship, Drug; D005445:Flunitrazepam / Q000008:administration & dosage; D005665:Furosemide / Q000627:therapeutic use; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007223:Infant; D011229:Preanesthetic Medication; D013997:Time Factors
chemical_list: D004071:Digitalis Glycosides; D002245:Carbon Dioxide; D015760:Alfentanil; D005445:Flunitrazepam; D005665:Furosemide