The effect of sevoflurane on cerebral blood flow velocity in children.
BACKGROUND
Sevoflurane is a suitable agent for neuroanesthesia in adult patients. In children, cerebrovascular carbon dioxide reactivity is maintained during hypo- and normocapnia under sevoflurane anesthesia. To determine the effects of sevoflurane on middle cerebral artery blood flow velocity (Vmca) in neurologically normal children, Vmca was measured both at different MAC values and at one MAC over a specified time period, using transcranial Doppler sonography.


METHODS
Twenty-six healthy children undergoing elective urological surgery were enrolled (16 patients in part I and 10 in part II). In part I of the study anesthesia comprised sevoflurane 0.5, 1.0 and 1.5 MAC in 30% oxygen and a caudal epidural block. Once steady state had been reached at each sevoflurane MAC level, three measurements of Vmca, mean arterial pressure (MAP) and heart rate (HR) were recorded. In part II of the study patients received sevoflurane 1.0 MAC over a 90-min period, with the same variables being recorded at 15-min intervals.


RESULTS
Vmca did not vary significantly at 0.5, 1.0 and 1.5 MAC sevoflurane. There was a significant decrease in MAP between 0.5 MAC and 1.0 MAC sevoflurane (P < 0.005) and also between 1.0 MAC and 1.5 MAC (P < 0.01). There was no significant change in Vmca over 90 min at 1.0 MAC sevoflurane.


CONCLUSIONS
Sevoflurane does not significantly affect cerebral blood flow velocity in healthy children at working concentrations.
Fairgrieve
R
R
Department of Anesthesia, The Hospital for Sick Children, University of Toronto, Ontario, Canada. ross.fairgrieve@yorkhill.scot.nhs.uk
Rowney
D A
DA
Karsli
C
C
Bissonnette
B
B
D000769:Anesthesia, Inhalation; D018685:Anesthetics, Inhalation / Q000494:pharmacology*; D001783:Blood Flow Velocity / Q000187:drug effects*; D001794:Blood Pressure / Q000187:drug effects; D002560:Cerebrovascular Circulation / Q000187:drug effects*; D002648:Child; D002675:Child, Preschool; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007223:Infant; D008738:Methyl Ethers / Q000494:pharmacology*; D020768:Middle Cerebral Artery; D000077149:Sevoflurane; D017585:Ultrasonography, Doppler, Transcranial
D018685:Anesthetics, Inhalation; D008738:Methyl Ethers; D000077149:Sevoflurane