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Cardiorespiratory effects of premedication for children
S M Audenaert1, Y Wagner, C L Montgomery
1Department of Anesthesiology, University of Louisville, Kentucky.
Anesthesia and Analgesia
|March 1, 1995
Summary
Pediatric preanesthetic medications have varying cardiorespiratory effects. Oral meperidine/pentobarbital decreased vital signs, while nasal ketamine/midazolam and rectal methohexital had minimal impact.
Area of Science:
- Anesthesiology
- Pediatric Medicine
- Pharmacology
Background:
- Pediatric preanesthetic medication effects on cardiorespiratory function are minimally studied.
- Reluctance exists in using premedication for children with serious illnesses like congenital heart disease.
Purpose of the Study:
- To evaluate the cardiorespiratory effects of different oral, nasal, and rectal preanesthetic medication regimens in young children.
- To identify significant physiological changes associated with specific premedication protocols.
Main Methods:
- A randomized prospective study involving 58 young children (average age 2.7 years).
- Administration of various oral, nasal, and rectal premedication regimens.
- Monitoring of cardiovascular and respiratory parameters.
Main Results:
- Oral meperidine (3 mg/kg) with pentobarbital (4 mg/kg) significantly decreased heart rate, mean arterial pressure, cardiac index, respiratory rate, and oxygen saturation.
- Nasal ketamine (5 mg/kg) with midazolam (0.2 mg/kg) showed no significant cardiorespiratory effects.
- Rectal methohexital (30 mg/kg) increased heart rate and decreased stroke volume without other significant effects.
Conclusions:
- Different preanesthetic medication routes and agents produce distinct cardiorespiratory effects in children.
- Nasal ketamine/midazolam appears to be a safe option regarding cardiorespiratory stability.
- Understanding these disparate effects is crucial for safe pediatric preanesthetic care.