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Epinephrine-halothane interactions in children.

H W Karl, D B Swedlow, K W Lee

    Anesthesiology
    |February 1, 1983
    PubMed
    Summary
    This summary is machine-generated.

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    Children undergoing halothane anesthesia tolerate higher doses of subcutaneous epinephrine for hemostasis. This study found no ventricular dysrhythmias in pediatric patients, suggesting increased safety margins.

    Area of Science:

    • Anesthesiology
    • Pediatric Cardiology

    Background:

    • Subcutaneous epinephrine for hemostasis during halothane anesthesia can cause ventricular dysrhythmias.
    • Children may be less susceptible to these dysrhythmias than adults.

    Purpose of the Study:

    • To prospectively survey heart rate and rhythm in pediatric patients receiving subcutaneous epinephrine during halothane anesthesia.

    Main Methods:

    • Continuous ECG, heart rate (HR), end-tidal halothane (ETHalo), and end-tidal carbon dioxide (ETCO2) monitoring in 83 children.
    • Mass spectrometry used to quantify ETHalo and avoid hypercarbia.
    • Epinephrine (0.4–15.7 µg/kg) administered subcutaneously for hemostasis.

    Main Results:

    • No ventricular dysrhythmias occurred in any child.

    Related Experiment Videos

  • One child experienced self-limited premature atrial contractions (PAC).
  • Heart rate increased in 63 children; 7 had ≥15% increase. No correlation found with dose, ETHalo, ETCO2, status, or age, but head/neck injections (excluding palate) significantly increased HR.

    • Conclusions:

    • Pediatric patients tolerate higher doses of subcutaneous epinephrine than adults during halothane anesthesia.
    • At least 10 µg/kg epinephrine may be safely used in normocarbic/hypocarbic pediatric patients without congenital heart disease.
    • Continuous ECG monitoring and caution are advised due to potential PAC and tachycardia.