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Cerebrovascular carbon dioxide reactivity in children anaesthetized with sevoflurane

D A Rowney1, R Fairgrieve, B Bissonnette

  • 1Department of Anaesthesia, The Hospital for Sick Children, University of Toronto, Ontario, Canada,.

British Journal of Anaesthesia
|May 7, 2002
PubMed

Insights

Sevoflurane anesthesia preserves cerebrovascular carbon dioxide reactivity (CCO2R) in children. Middle cerebral artery blood flow velocity increased with CO2 levels, indicating maintained brain blood flow regulation.

Area of Science:

  • Anesthesiology
  • Pediatric Anesthesia
  • Cerebrovascular Physiology

Background:

  • Assessing the impact of sevoflurane on cerebrovascular carbon dioxide reactivity (CCO2R) is crucial for pediatric anesthesia.
  • Cerebral blood flow velocity (CBFV) is a key indicator of cerebrovascular function.

Purpose of the Study:

  • To evaluate the effect of sevoflurane on CCO2R in children undergoing surgery.
  • To measure CBFV at varying end-tidal carbon dioxide (PE'CO2) levels.

Main Methods:

  • Transcranial Doppler sonography was used to measure CBFV in 16 healthy children (18 months to 7 years).
  • Anesthesia involved 1.0 MAC sevoflurane, air/oxygen, and caudal epidural block.
  • PE'CO2 was adjusted to 25, 35, 45, and 55 mm Hg while maintaining ventilation.

Main Results:

  • CBFV significantly increased as PE'CO2 rose from 25 to 45 mm Hg (P<0.001).
  • No significant increase in CBFV was observed between 45 and 55 mm Hg PE'CO2.
  • Mean heart rate and arterial pressure remained stable throughout the study.

Conclusions:

  • Cerebrovascular carbon dioxide reactivity (CCO2R) is maintained in healthy children under sevoflurane anesthesia.
  • Sevoflurane at 1.0 MAC appears safe for maintaining cerebrovascular regulation in this pediatric population.
Abstract

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