title: Intraosseous anesthesia in hemodynamic studies in children with cardiopathy.
abstract: OBJECTIVE
  Intraosseous (IO) access has been used with good results in emergency situations, when venous access is not available for fluids and drugs infusion. The objective of this study was to evaluate IO a useful technique for anesthesia and fluids infusion during hemodynamic studies and when peripheral intravascular access is unobtainable. The setting was an university hospital hemodynamics unit, and the subjects were twenty one infants with congenital heart disease enrolled for elective hemodynamic study diagnosis.
  
  
  METHODS
  This study compared the effectiveness of IO access in relation to IV access for infusion of anesthetics agents (ketamine, midazolam, and fentanyl) and fluids during hemodynamic studies. The anesthetic induction time, procedure duration, anesthesia recovery time, adequate hydration, and IV and IO puncture complications were compared between groups.
  
  
  RESULTS
  The puncture time was significantly smaller in IO group (3.6 min) that in IV group (9.6 min). The anesthetic onset time (56.3 second) for the IV group was faster than IO group (71.3 second). No significant difference between groups were found in relation to hydration (IV group, 315.5 mL vs IO group, 293.2 mL), and anesthesia recovery time (IO group, 65.2 min vs IV group, 55.0 min). The puncture site was reevaluated after 7 and 15 days without signs of infection or other complications.
  
  
  CONCLUSIONS
  Results showed superiority for IO infusion when considering the puncture time of the procedure. Due to its easy manipulation and efficiency, hydration and anesthesia by IO access was satisfactory for hemodynamic studies without the necessity of other infusion access.
authors.affiliation: Divisão de Anestesiologia e Terapia Cirúrgica do Instituto do Coração of Hospital das Clínicas of Faculdade de Medicina of Universidade de São Paulo (InCor- HC-FM-USP), Brazil.
authors.forename: Ana Cristina
authors.initials: AC
authors.lastname: Aliman
authors.forename: Marilde de Albuquerque
authors.initials: Mde A
authors.lastname: Piccioni
authors.forename: João Luiz
authors.initials: JL
authors.lastname: Piccioni
authors.forename: José Luiz
authors.initials: JL
authors.lastname: Oliva
authors.forename: José Otávio Costa
authors.initials: JO
authors.lastname: Auler Júnior
mesh_terms: D000758:Anesthesia / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006331:Heart Diseases / Q000151:congenital* / Q000503:physiopathology*; D006439:Hemodynamics; D006801:Humans; D007223:Infant; D017148:Infusions, Intraosseous; D008297:Male