• Medicine · Dec 2017

    Randomized Controlled Trial Comparative Study Observational Study

    Comparison of hemodynamic effects of sevoflurane and ketamine as basal anesthesia by a new and direct monitoring during induction in children with ventricular septal defect: A prospective, randomized research.

    • Ding Han, Ya-Guang Liu, Shoudong Pan, Yi Luo, Jia Li, and Chuan Ou-Yang.
    • Anesthesia Department, Capital Institute of Pediatrics affiliated Children's Hospital Anesthesia Center, Capital Medical University affiliated Beijing Anzhen Hospital Cardiac Surgery Division, Capital Institute of Pediatrics affiliated Children's Hospital Clinical Physiology Laboratory, Capital Institute of Pediatrics, Beijing, China.
    • Medicine (Baltimore). 2017 Dec 1; 96 (50): e9039.

    BackgroundSevoflurane and ketamine are commonly used to obtain sedation and facilitate intravenous anesthetic induction in children undergoing cardiac surgery who are uncooperative. We used a new and direct systemic hemodynamic monitoring technique pressure recording analytical method and compared the hemodynamic effects of sevoflurane and ketamine to facilitate intravenous anesthetic induction.MethodsForty-four children with ventricular septal defect (2.2 ± 1.2 years) were enrolled and randomized to receive sevoflurane (Group S) or intramuscular ketamine (Group K) for sedation, followed by intravenous midazolam-sufentanil induction and tracheal intubation. Recorded parameters included heart rate (HR), arterial pressures, stroke volume index (SVI), cardiac index (CI), systemic vascular resistance index (SVRI), the maximal slope of systolic upstroke (dp/dtmax) after sedation obtained with sevoflurane or ketamine, 1, 2, 5 minutes after midazolam-sufentanil, 1, 2, 5, and 10 minutes after tracheal intubation. Rate-pressure product (RPP) and cardiac power output (CPO) were calculated.ResultsAs compared with Group S, Group K had faster decreases during intravenous anesthetic induction in arterial pressures (P < .01 for all), higher HR, arterial pressures, SVRI, dp/dtmax, RPP, lower SVI, CI, CPO (P < .05 for all) during the study period.ConclusionAs compared with sevoflurane, ketamine facilitated intravenous anesthetic induction exerts unfavorable effects on systemic hemodynamic and myocardial energetic in children with ventricular septal defect.Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.

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