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[Isoflurane in pediatric anesthesia].

J Hausdörfer, H Hagemann, M Bell

    Der Anaesthesist
    |June 1, 1986
    PubMed
    Summary
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    Isoflurane anesthesia in children aged 1-10 preserved hemodynamic parameters better than halothane. Isoflurane also provided faster, deeper, and longer muscle relaxation, though it depressed spontaneous respiration.

    Area of Science:

    • Pediatric Anesthesiology
    • Pharmacology

    Background:

    • Halothane has been a standard anesthetic agent for pediatric patients.
    • Isoflurane offers potential advantages in hemodynamic stability and muscle relaxation.

    Purpose of the Study:

    • To compare the effects of isoflurane (I) versus halothane (H) anesthesia on hemodynamic parameters, spontaneous respiration, and neuromuscular blockade in children.
    • To evaluate the dose-dependent effects of vecuronium bromide on muscle relaxation under isoflurane and halothane anesthesia.

    Main Methods:

    • Seventy pediatric patients (1-10 years) received isoflurane or halothane anesthesia (O2:N2O = 1:3).
    • Hemodynamic parameters, respiratory function (respiratory rate, minute volume, end-tidal CO2, pCO2), and airway pressures were monitored.
    • Neuromuscular blockade was assessed using the train-of-four (TOF) method with varying doses of vecuronium bromide.

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    Main Results:

    • Isoflurane maintained hemodynamic parameters well, with increased pulse rate and decreased diastolic pressure due to vasodilation. Baroreceptor reflexes appeared more functional under isoflurane.
    • Spontaneous respiration was depressed by isoflurane, leading to CO2 accumulation. Younger children experienced more airway issues with isoflurane compared to halothane.
    • Isoflurane resulted in a faster onset, more profound, and longer duration of muscle relaxation with vecuronium bromide compared to halothane, with statistically significant differences.

    Conclusions:

    • Isoflurane is a viable anesthetic agent for pediatric patients, offering stable hemodynamics and effective muscle relaxation.
    • Careful monitoring of spontaneous respiration and airway pressures is crucial when using isoflurane in younger children.
    • Isoflurane enhances the effects of neuromuscular blocking agents like vecuronium bromide in pediatric anesthesia.