[Sufentanil-N2O2/O2 or halothane-N2O/O2 anesthesia in surgery of infants and children with congenital heart defects. Hemodynamics and plasma catecholamines].
Sufentanil-nitrous oxide/oxygen anesthesia was compared to halothane-nitrous oxide/oxygen anesthesia in 44 infants and children undergoing cardiac surgery. Patients were randomly assigned to one of the two techniques studied, with 22 patients in each group. The mean weight was 8.3 (4.4-15.8) kg in the sufentanil (S) group and 11.7 (5.2-18) kg in the halothane (H) group. All patients were premedicated with IM atropine 0.01 mg/kg, morphine 0.2 mg/kg, and flunitrazepam 0.04 mg/kg. In the S group 1 micrograms/kg S was given intravenously for induction, followed by a cumulative dose of 4 micrograms/kg S until the beginning of surgery. In the H group anesthesia was induced with H 0.5-1.0 vol.% and for deepening of anesthesia increasing H concentrations of 0.5-1.0-1.5 vol.% were applied. Following intubation all patients were ventilated with nitrous oxide/oxygen (1:1). There were no significant differences between the two groups in systolic, diastolic and mean arterial blood pressures or in heart-rate response to induction and intubation. Peripheral arterial oxygen saturation increased significantly in cyanotic patients in both groups following induction. There were dose-dependent decreases in heart rate and small but significant decreases in mean and diastolic arterial pressure in the S group during deepening of anesthesia. There was a significantly greater decrease in systolic, diastolic and mean blood pressures during the same period in the H group whereas the reduction in heart rate was minimal. In addition, in 5 of 22 patients receiving H there were episodes of nodal rhythms with dramatic decreases in systemic arterial pressure and peripheral arterial oxygen saturation in cyanotic patients.(ABSTRACT TRUNCATED AT 250 WORDS)
Barankay
A
A
Institut für Anaesthesiologie, Deutsches Herzzentrum München.
Späth
P
P
Mitto
P
P
Vogt
W
W
Richter
J A
JA
D000768:Anesthesia, General; D000769:Anesthesia, Inhalation; D000771:Anesthesia, Intravenous; D002675:Child, Preschool; D002986:Clinical Trials as Topic; D004837:Epinephrine / Q000097:blood*; D005283:Fentanyl / Q000031:analogs & derivatives*; D006221:Halothane; D006330:Heart Defects, Congenital / Q000097:blood / Q000503:physiopathology / Q000601:surgery*; D006439:Hemodynamics; D006801:Humans; D007223:Infant; D009609:Nitrous Oxide; D009638:Norepinephrine / Q000097:blood*; D010100:Oxygen; D011897:Random Allocation; D017409:Sufentanil
D017409:Sufentanil; D009609:Nitrous Oxide; D010100:Oxygen; D005283:Fentanyl; D006221:Halothane; D009638:Norepinephrine; D004837:Epinephrine
Sufentanil-N2O2- bzw. Halothan-N2O/O2-Anaesthesie bei Operationen an Säuglingen und Kindern mit angeborenen Herzfehlern. Hämodynamik und Plasmakatecholamine.