Sevoflurane for central venous catheterization in non-intubated neonates.
OBJECTIVE
Sedation in neonates undergoing invasive prodedures as central venous catheterization (CVC) remains contro versial. Sevoflurane is an inhaled anesthetic whose periods of action and elimination are very short. The objective of this study was to evaluate the use of sevoflurane for sedation for central venous catheterization (CVC) in non-intubated neonates and preterms.


METHODS
Thirty three (33) consecutive patients (range: 1-31 days old, 26 to 40 weeks GA, weighing 580 to 3200 g) were included over a 4 months period. Sevoflurane was progressively increased, until loss of consciousness and motor response to stimulation. FiO(2), heart rate (HR), mean arterial pressure (MAP), duration of the procedure and the ease of the procedure were recorded.


RESULTS
HR was very stable, but MAP dropped significantly. No patient required intubation. The ease of the procedure was scored as average 13 times and excellent 20 times.


CONCLUSIONS
The use of sevoflurane in neonates for CVC is feasible and achieve the goals of procedural sedation. The pharmacokinetic of sevoflurane enabled rapid adjustment of the depth of sedation. Sevoflurane appears to be a new agent at the disposal of neonatologists. Its use does not come without risks, especially for smaller preterms, which the treating clinician must anticipate.
Vialet
Renaud
R
Department of Anesthesiology, Pediatric and Neonatal Intensive Care Unit, North University Hospital, Marseille, France. renaud.vialet@ap-hm.fr
Michel
Fabrice
F
Hassid
Sophie
S
Di Marco
Jean-Noël
JN
Martin
Claude
C
D018685:Anesthetics, Inhalation / Q000009:adverse effects / Q000493:pharmacokinetics / Q000494:pharmacology*; D001794:Blood Pressure / Q000187:drug effects; D002405:Catheterization, Central Venous; D054810:Deep Sedation; D004305:Dose-Response Relationship, Drug; D006339:Heart Rate / Q000187:drug effects; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D008738:Methyl Ethers / Q000009:adverse effects / Q000493:pharmacokinetics / Q000494:pharmacology*; D000077149:Sevoflurane; D013997:Time Factors; D016896:Treatment Outcome
D018685:Anesthetics, Inhalation; D008738:Methyl Ethers; D000077149:Sevoflurane