Efficacy of inhalational sevoflurane anesthesia induction on inhibiting the stress response to endotracheal intubation in children with congenital heart disease

C.-H. Wang, J. Luo, J. Li, J.-Z. Zhang, S.-Y. Huang, W. Shao, H.-S. MA

Department of Anesthesiology, Yantaishan Hospital, Yantai, Shandong Province, China. factory_2001@sohu.com

---

• Pharmacology

OBJECTIVE: To investigate the efficacy of inhalational sevoflurane anesthesia induction on inhibiting the stress response to endotracheal intubation in pediatric patients with congenital heart disease (CHD).

PATIENTS AND METHODS: Forty ASA physical status I/II pediatric patients scheduled for interventricular septal defect repair or interatrial septal defect repair, were randomly divided into two groups (20 each): intravenous induction group (Group C) and inhalational sevoflurane anesthesia induction group (Group D). In group C, anesthesia was induced with midazolam, pipecuronium bromide and fentanyl, and the children were examined by radial artery monitoring after the consciousness extinction. Also, they were endotracheally intubated after muscle relaxation. In group D, anesthesia was induced with inhalation of 8% sevoflurane and 6 L/min oxygen, and the children were examined by radial artery monitoring after the consciousness extinction and were endotracheally intubated 4 min later. Before anesthesia induction (T₀), consciousness extinction (T₁), endotracheal intubation (T₂), endotracheal intubation (T₃), and after endotracheal intubation (T₄), 1 and 3 min after intratracheal intubation (T_5,6), HR and bispectral index (BIS) were monitored. The MAP of T2-T6 points was recorded. Ulnar vein blood samples were taken for determination of Endothelin (ET) and Thromboxane A₂(TXA₂) in the points of consciousness extinction, and 5 and 10 min after endotracheal.

RESULTS: All the children were well examined by endotracheal intubation. Compared with the baseline value at T0, there was no significant difference of HR in group D, but the HR of group C was decreased at T₂, T₃, T₄ and T₆. The BIS of the two groups were decreased at T₁-T₆ (p<0.05). Compared with the values at T₂, they were increased at T₅ and T₆ in group C, and increased at T₆ in group D (p<0.05). Compared with group C, the MAP of group D was decreased at T₅, and the BIS of the two groups was decreased at T₂-T₆ (p<0.05). There were no significant differences of ET and TXA2 between groups.

CONCLUSIONS: It is well inhibited the endotracheal intubation stress response in children with congenital heart diseases using sevoflurane inhalational anesthesia induction.

Free PDF Download