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Lactate, pyruvate, and excess lactate during ether and halothane anesthesia in infants and children
Insights
Diethyl ether anesthesia significantly increased blood lactate, pyruvate, and excess lactate (XL) in pediatric patients undergoing cleft repair. Halothane anesthesia showed no significant metabolic changes, suggesting ether
Area of Science:
- Anesthesiology
- Pediatric Surgery
- Clinical Chemistry
Background:
- Pediatric anesthesia carries risks, and understanding metabolic responses is crucial for patient safety.
- Diethyl ether and halothane are common anesthetics in pediatric surgery, with differing physiological impacts.
- Lactate, pyruvate, and excess lactate (XL) are key indicators of tissue oxygenation and metabolic stress.
Purpose of the Study:
- To investigate the impact of diethyl ether and halothane anesthesia on blood lactate, pyruvate, and excess lactate (XL) levels in pediatric patients.
- To compare the metabolic responses to these anesthetics in children aged 7 months to 6 years.
- To determine if anesthetic-induced metabolic changes in children differ from those observed in adults.
Main Methods:
- Arterial blood samples were collected from 33 pediatric patients (7 months to 6 years) during harelip or cleft palate repair.
- Lactate, pyruvate, and excess lactate (XL) levels were measured at baseline and over a 2-hour period post-anesthesia induction.
- Patients received either diethyl ether or halothane anesthesia, and physiological parameters like temperature were monitored.
Main Results:
- Diethyl ether anesthesia caused a significant rise in lactate, pyruvate, and XL at 60 minutes, with no further increase thereafter.
- Halothane anesthesia did not result in significant changes in lactate, pyruvate, or XL levels.
- The observed metabolic changes with ether anesthesia were not correlated with patient age or body temperature.
- Anesthetic effects on lactate, pyruvate, and XL in children were comparable to those reported in adult studies.
Conclusions:
- Diethyl ether anesthesia induces a transient increase in blood lactate, pyruvate, and excess lactate in pediatric patients, similar to adults.
- Halothane appears to be metabolically neutral in this pediatric surgical context.
- These findings highlight the importance of monitoring metabolic markers during pediatric anesthesia, particularly when using agents like diethyl ether.
Abstract:
Arterial blood lactate, pyruvate, and excess lactate (XL) were measured and calculated in 33 patients aged 7 months to 6 years over a period of 2 hours during repair of harelip or cleft palate. When the anesthetic was diethyl ether, lactate and pyruvate levels rose significantly 60 minutes after induction of anesthesia but did not rise thereafter. Excess lactate appeared 60 minutes after induction of ether anesthesia, but it, too, showed no further increase. When the anesthetic was halothane there was no significant change in lactate, pyruvate, or XL. Changes with ether were not age-related, nor could they be correlated with changes in rectal or skin temperature. The responses of lactate, pyruvate and XL to ether anesthesia in the present study were not significantly different from those found by others in adults.