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Haemodynamic effects of rectal methohexitone for induction of anaesthesia in children
R B Forbes1, D J Murray, D L Dull
1Department of Anesthesia, University of Iowa College of Medicine, Iowa City 52242.
Insights
Rectal methohexitone (25 mg.kg-1) for pediatric anesthesia induction minimally impacts hemodynamics. Heart rate increased significantly, but blood pressure and cardiac output remained stable in healthy children.
Area of Science:
- Pediatric Anesthesiology
- Cardiovascular Physiology
- Pharmacodynamics
Background:
- Rectal methohexitone is a common induction agent in pediatric anesthesia.
- Understanding its hemodynamic effects is crucial for patient safety.
- Limited data exists on the specific cardiovascular impact of rectal methohexitone in young children.
Purpose of the Study:
- To evaluate the hemodynamic effects of rectal methohexitone in pediatric patients.
- To assess changes in heart rate, blood pressure, and cardiac output following induction.
Main Methods:
- Pulsed Doppler and two-dimensional echocardiography were utilized.
- Hemodynamic parameters (heart rate, blood pressure, cardiac output, stroke volume, ventricular volumes) were measured in 12 children (mean age 32.4 months).
- Measurements were taken before and immediately after anesthesia induction with 25 mg.kg-1 rectal methohexitone.
Main Results:
- A significant increase in heart rate was observed post-induction.
- Blood pressure, cardiac index, stroke volume, and ejection fraction showed no significant changes.
- Left ventricular end-diastolic and end-systolic volumes remained stable.
Conclusions:
- Rectal administration of 2% methohexitone for anesthesia induction in healthy pediatric patients has minimal adverse hemodynamic effects.
- The observed increase in heart rate is not accompanied by significant changes in other major cardiovascular parameters.
- Rectal methohexitone appears to be a hemodynamically stable option for pediatric anesthesia induction.
Abstract:
Pulsed Doppler and two-dimensional echocardiography were used to determine the haemodynamic effects of rectal methohexitone in 12 children 32.4 +/- 3.8 months old and weighing 13.3 +/- 1.1 kg (mean +/- SEM). Heart rate, blood pressure and echocardiographic measurements of cardiac output, stroke volume and left ventricular end-diastolic and end-systolic volumes were obtained prior to the induction of anaesthesia. Anaesthesia was induced with 25 mg.kg-1 two per cent rectal methohexitone. Immediately following the onset of sleep all cardiovascular measurements were repeated. Following the induction of anaesthesia with rectal methohexitone there was a significant increase in heart rate. Blood pressure, cardiac index, stroke volume and ejection fraction were unchanged. It is concluded that rectal administration of two per cent methohexitone for the induction of anaesthesia in healthy paediatric patients has minimal haemodynamic effect.