Cerebral blood flow velocity in children anaesthetized with desflurane.
BACKGROUND
Desflurane allows for rapid emergence and changes in depth of anaesthesia which makes it especially suitable for neuroanaesthesia. This study was designed to determine the effects of different desflurane concentrations on cerebral blood flow velocity (CBFV) in healthy children.


METHODS
Twenty children, aged 1-7 years undergoing urological surgery were studied. Anaesthesia was induced with sevoflurane in oxygen. After tracheal intubation, sevoflurane was discontinued and ventilation with desflurane in air/oxygen was initiated and normoventilation maintained. A caudal block was performed. The patients were randomized to receive three different desflurane concentrations (0.5, 1.0 and 1.5 MAC). Fifteen minutes were allowed to reach steady-state at which time CBFV was measured by transcranial Doppler sonography. Mean arterial pressure (MAP) and heart rate (HR) were simultaneously recorded at 1-min intervals.


RESULTS
Cerebral blood flow velocity increased from 0.5 to 1.0 MAC (P < 0.05), but not from 1.0 to 1.5 MAC. HR increased from 0.5 to 1.0 (P < 0.001) and from 1.0 to 1.5 MAC (P < 0.001), whereas the MAP decreased only from 0.5 to 1.0 MAC (P < 0.001).


CONCLUSIONS
Desflurane in concentrations of 1.0 and 1.5 MAC in children increases CBFV significantly when compared with 0.5 MAC. These changes were associated with a significant increase in HR and decrease in MAP.
Luginbuehl
Igor A
IA
Department of Anaesthesia, The Hospital for Sick Children, University of Toronto, Toronto, Canada.
Fredrickson
Michael J
MJ
Karsli
Cengiz
C
Bissonnette
Bruno
B
D000769:Anesthesia, Inhalation; D018685:Anesthetics, Inhalation; D001794:Blood Pressure / Q000187:drug effects; D002560:Cerebrovascular Circulation / Q000187:drug effects*; D002648:Child; D002675:Child, Preschool; D000077335:Desflurane; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007223:Infant; D007530:Isoflurane / Q000031:analogs & derivatives*; D008297:Male; D017585:Ultrasonography, Doppler, Transcranial
D018685:Anesthetics, Inhalation; D000077335:Desflurane; D007530:Isoflurane