Document Detail


The transesophageal Doppler and hemodynamic effects of epidural anesthesia in infants anesthetized with sevoflurane and sufentanil.
MedLine Citation:
PMID:  17578955     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: It is thought that pediatric epidural anesthesia (EA) provides hemodynamic stability in children. However, when compared with information relating to adults, little is known about the hemodynamic effects of epidural EA on cardiac output (CO) in infants. METHODS: Using transesophageal Doppler to monitor CO, we prospectively studied 14 infants <10 kg who were scheduled for abdominal surgery. During sevoflurane general anesthesia, CO transesophageal Doppler monitoring was performed before and after lumbar EA with 0.75 mL/kg of 0.25% bupivacaine and 1:200,000 adrenaline. CO, arterial blood pressure, and heart rate were measured before and 5, 15, and 20 min after performance of EA. RESULTS: In patients anesthetized with sevoflurane and sufentanil, EA resulted in an increase in stroke volume by 29% (P < 0.0001) and a decrease in heart rate by 13% (P < 0.0001). EA also induced a significant decrease in systolic, diastolic, mean arterial blood pressure, and systemic vascular resistance by 11%, 18%, 15%, and 25%, respectively. Conversely, CO remained unchanged. CONCLUSIONS: The increase in stroke volume observed is probably explained by optimization of afterload because of the sympathetic blockade induced by EA. These results confirm that EA provides hemodynamic stability in infants weighing <10 kg and supports the use of EA in this pediatric population.
Authors:
Antoine Monsel; Amelie Salvat-Toussaint; Philippe Durand; Vincent Haas; Catherine Baujard; Philippe Rouleau; Souad El Aouadi; Dan Benhamou; Karin Asehnoune
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Anesthesia and analgesia     Volume:  105     ISSN:  1526-7598     ISO Abbreviation:  Anesth. Analg.     Publication Date:  2007 Jul 
Date Detail:
Created Date:  2007-06-20     Completed Date:  2007-07-19     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  1310650     Medline TA:  Anesth Analg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  46-50     Citation Subset:  AIM; IM    
Affiliation:
Service d'Anesthésie-Réanimation et Unité Propre de Recherche de l'Enseignement Supérieur-Equipe d'Accueil (UPRES-EA 392), Le Kremlin Bicêtre, France.
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MeSH Terms
Descriptor/Qualifier:
Anesthesia, Epidural* / methods
Cardiac Output / drug effects*,  physiology
Echocardiography, Doppler* / methods
Echocardiography, Transesophageal* / methods
Humans
Infant
Methyl Ethers / pharmacology*
Prospective Studies
Stroke Volume / physiology
Sufentanil / pharmacology*
Chemical
Reg. No./Substance:
0/Methyl Ethers; 28523-86-6/sevoflurane; 56030-54-7/Sufentanil

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


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