Document Detail


Trendelenburg positioning does not prevent a decrease in cardiac output after induction of anaesthesia with propofol in children.
MedLine Citation:
PMID:  16879471     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND OBJECTIVE: Induction of anaesthesia may cause decreased cardiac output and blood pressure. Head-down tilt is often the first clinical step to treat hypotension. The objective of this randomized single centre study was to determine, with the use of impedance cardiography (ICG), whether Trendelenburg positioning modifies the haemodynamic response to propofol/fentanyl induction of anaesthesia in ASA I children. METHODS: Thirty ASA I children aged between 7 and 16 years scheduled for elective minor orthopaedic surgery were included. After intravenous induction with propofol and fentanyl in the head-down group (HDG, n = 15), 5 min of 20 degrees head-down tilt was applied. In the supine group (SG, n = 15), no change in the supine position was made. Heart rate (HR), mean arterial blood pressure (MABP), end-tidal carbon dioxide (ETCO(2)), stroke volume index (SVI), cardiac index (CI), systemic vascular resistance index (SVRI) and Heather index (HI) were recorded before (B), at 3 (A(3)), 5 (A(5)) and 8 (A(8)) minutes after induction in each group. RESULTS: After induction, a significant decrease in CI, MABP, HR and HI was recorded in both groups. In the study group, significantly lower values of HR (66 vs. 78 beat/min) and higher values of SVI (42.9 vs. 40.6 ml/min/m(2)) were measured at A(3) compared with the control group. After induction, no difference in CI and SVRI was found between the two groups. CONCLUSION: The present study shows that cardiac performance is not improved by Trendelenburg positioning after propofol/fentanyl induction of anaesthesia in children.
Authors:
A Kardos; C Földesi; A Nagy; A Sáringer; A Kiss; G Kiss; P Marschalkó; M Szabó
Publication Detail:
Type:  Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Acta anaesthesiologica Scandinavica     Volume:  50     ISSN:  0001-5172     ISO Abbreviation:  Acta Anaesthesiol Scand     Publication Date:  2006 Aug 
Date Detail:
Created Date:  2006-08-01     Completed Date:  2006-12-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370270     Medline TA:  Acta Anaesthesiol Scand     Country:  England    
Other Details:
Languages:  eng     Pagination:  869-74     Citation Subset:  IM    
Affiliation:
Paediatric Intensive Care Unit, Heim Pál Children's Hospital, Ullöi Str. 89, 1086 Budapest, Hungary. dr.kardos@axelero.hu
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Anesthesia, Intravenous*
Anesthetics, Intravenous*
Blood Pressure
Breath Tests
Carbon Dioxide / analysis
Cardiac Output*
Cardiography, Impedance
Child
Female
Fentanyl
Head-Down Tilt*
Heart Rate
Humans
Male
Orthopedic Procedures
Propofol*
Stroke Volume
Vascular Resistance
Chemical
Reg. No./Substance:
0/Anesthetics, Intravenous; 124-38-9/Carbon Dioxide; 2078-54-8/Propofol; 437-38-7/Fentanyl

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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