• Ding Han, Siyuan Xie, Shoudong Pan, and Yangchuan Ou.
• Anesthesia Department, Children's Hospital affiliated to Capital Institute of Pediatrics, Beijing, China.
• J. Cardiothorac. Vasc. Anesth. 2024 Oct 22.

ObjectivesThe effects of anesthetics on electroencephalograms and cerebral perfusion remain understudied in children with congenital heart disease. With regard to this, we compared inhalational anesthesia induction and intravenous anesthesia induction.DesignA randomized controlled trial.SettingOperating room in 2 tertiary hospitals.ParticipantsA cohort of 116 pediatrics patients undergoing cardiac surgery.Measurements And Main ResultsThe patients were randomly assigned to either the intravenous group (n = 58) or the inhalational group (n = 58). The inhalational group received anesthesia induction with 4% to 6% sevoflurane and a bolus of pipecuronium 0.2 mg/kg, whereas the intravenous group received anesthesia induction with intravenous midazolam 0.2 mg/kg, pipecuronium 0.2 mg/kg, and sufentanil 1 μg/kg. Ten minutes after tracheal intubation, the following parameters were measured: spectral edge frequency, burst suppression event, patient state index, middle cerebral artery blood flow velocity, cerebral oxygen saturation, and hemodynamic parameters. In comparison with the intravenous group, the inhalational group exhibited significant increases in 95% spectral edge frequency, ratio of burst suppression event, blood flow velocity in the middle cerebral artery, and cerebral oxygen saturation (p < 0.05 for all), as well as decreases in systolic pressure, diastolic pressure, cardiac index, and the maximal slope of systolic upstroke (p < 0.05 for all).ConclusionsThe administration of sevoflurane for anesthesia induction results in more burst suppression, while also demonstrating superior cerebral perfusion when compared with the use of intravenous medications for anesthesia induction.Trial RegistrationChinese Clinical Trial Registry (ChiCTR1800015946).Copyright © 2024 Elsevier Inc. All rights reserved.

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