Hemodynamic changes in children with Down syndrome during and following inhalation induction of anesthesia with sevoflurane.
OBJECTIVE
To evaluate whether children with Down Syndrome are at increased risk of bradycardia and hypotension during and following sevoflurane induction.


METHODS
Retrospective study.


METHODS
University-affiliated children's hospital.


METHODS
The records of children with Down syndrome and a sample matched by age, congenital heart defect, and ASA physical status, were searched. Demographics, history of Down syndrome or congenital heart anomaly, heart rate (HR), mean arterial pressure (MAP), and end-tidal concentration of sevoflurane (EtSevo) at baseline and following induction were recorded.


RESULTS
96 children with Down syndrome were identified from 11,201 pediatric anesthetics (< 1%). Demographics were similar in the matched sample. The Down syndrome group was more likely to experience bradycardia and had greater decreases in HR from baseline. These findings were similar for children with or without congenital heart defects. There were no differences between groups in the number who were treated with a pharmacologic agent.


CONCLUSIONS
A significantly higher prevalence and degree of bradycardia occurred in children with Down syndrome during and following sevoflurane induction, which was corrected by decreasing the concentration of sevoflurane and airway manipulation.
Department of Anesthesiology, University of Michigan Health Systems, F3900 Mott Hospital, Ann Arbor, MI 48109-5211, USA. wenyubai@med.umich.edu
Wenyu
W
Bai
Terri
T
Voepel-Lewis
Shobha
S
Malviya
D000769:Anesthesia, Inhalation; D018685:Anesthetics, Inhalation / Q000494:pharmacology*; D002648:Child; D002675:Child, Preschool; D004314:Down Syndrome / Q000503:physiopathology*; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008738:Methyl Ethers / Q000494:pharmacology*; D012189:Retrospective Studies; D000077149:Sevoflurane
D018685:Anesthetics, Inhalation; D008738:Methyl Ethers; D000077149:Sevoflurane