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Comparison of haemodynamic changes induced by sevoflurane and halothane in paediatric patients
S Kawana1, J Wachi, M Nakayama
1Department of Anesthesiology, Sapporo Medical University School of Medicine, Japan.
Insights
Sevoflurane and halothane have similar hemodynamic effects in children. Sevoflurane showed a higher heart rate increase than halothane at 2 MAC, but both anesthetic agents were comparable otherwise.
Area of Science:
- Anesthesiology
- Pediatric Anesthesia
- Cardiovascular Physiology
Background:
- Halothane has been a standard anesthetic for children, but sevoflurane is increasingly used.
- Understanding the comparative hemodynamic effects is crucial for patient safety.
Purpose of the Study:
- To compare the hemodynamic effects of sevoflurane and halothane at 1 and 2 Minimum Alveolar Concentration (MAC) in pediatric patients.
Main Methods:
- Thirty-eight children (1-6 years) were randomized into four groups: sevoflurane (S1, S2) and halothane (H1, H2) at 1 and 2 MAC.
- Hemodynamic parameters including mean blood pressure (mBP), stroke volume index (SVI), heart rate (HR), and cardiac index (CI) were measured using impedance cardiometry.
Main Results:
- Mean blood pressure and stroke volume index decreased similarly across all groups.
- Heart rate increased in sevoflurane groups (S1, S2) and halothane 2 MAC (H2), but not halothane 1 MAC (H1).
- The heart rate increase in S2 was significantly higher than in H2. Cardiac index showed a non-significant trend towards decrease in all groups.
Conclusions:
- Sevoflurane exhibits comparable hemodynamic depressant effects to equipotent halothane concentrations in children.
- A notable difference was the greater heart rate increase with sevoflurane at 2 MAC compared to halothane.
Abstract:
The purpose of this study is to investigate the haemodynamic effects of 1 MAC and 2 MAC of sevoflurane in children in comparison with halothane. Thirty-eight children (aged from one to six years, average age; 3.6 +/- 0.2 yr) were randomly assigned to four groups, depending on the dose and agent (1 and 2 MAC of sevoflurane: S1 and S2; 1 and 2 MAC of halothane: H1 and H2, respectively). After collecting control data during 0.2 MAC of either anaesthetic, end-expired anaesthetics were kept at 1 MAC or 2 MAC for 15 min. Mean blood pressure (mBP) and stroke volume index (SVI), measured by impedance cardiometry, decreased in all groups without differences between groups. Heart rate (HR) increased in groups S1, S2 and H2 but not in group H1. The HR in S2 was higher than that in H2. The cardiac index (CI), a product of SVI and HR, tended to decrease but not significantly in all groups. These results suggested that the haemodynamic depressant effects of sevoflurane in children were similar to those of equipotent halothane concentration except for HR.