Related Experiment Videos
Cardiovascular effects of i.v. induction in children: comparison between propofol and thiopentone
C S Aun1, R Y Sung, M E O'Meara
1Department of Anaesthesia and Intensive Care, Prince of Wales Hospital, Chinese University of Hong Kong, Shatin, New Territories.
Insights
Propofol caused a greater reduction in mean arterial pressure compared to thiopentone in Chinese children. However, cardiac index changes were similar, with blunted baroreflex responses observed in younger children.
Area of Science:
- Anesthesiology
- Pediatric Anesthesia
- Cardiovascular Physiology
Background:
- Induction agents like propofol and thiopentone are crucial in pediatric anesthesia.
- Understanding their hemodynamic effects in children is vital for safe anesthetic practice.
Purpose of the Study:
- To compare the hemodynamic responses to intravenous propofol and thiopentone during anesthesia induction in Chinese children.
- To investigate the influence of age on these responses.
Main Methods:
- A comparative study involving 41 healthy Chinese children undergoing anesthesia induction.
- Patients were divided into four age- and agent-based groups (propofol vs. thiopentone).
- Hemodynamic parameters including mean arterial pressure, heart rate, and cardiac index were monitored using oscillotonometer and echocardiography.
Main Results:
- Propofol resulted in a significantly greater reduction in mean arterial pressure (28-31%) compared to thiopentone (14-21%).
- No significant difference in the reduction of cardiac index was observed between the two agents.
- Baroreflex-mediated increases in heart rate and systemic vascular resistance were less pronounced with propofol, and more attenuated in children under 2 years.
Conclusions:
- Propofol induces a more significant hypotensive effect than thiopentone in Chinese children.
- Age influences baroreceptor reflex sensitivity during anesthetic induction.
- Both agents demonstrate comparable effects on cardiac index post-induction.
Abstract:
We have compared the haemodynamic responses to i.v. propofol 2.5 mg kg-1 with those to thiopentone 5.0 mg kg-1 in 41 healthy Chinese children at induction of anaesthesia. They were allocated to four groups according to their age and induction agent received: group 1 < 2 yr, propofol, n = 9; group II < 2 yr, thiopentone, n = 9; group III 2-12 yr, propofol, n = 12; group IV 2-12 yr, thiopentone, n = 11. Anaesthesia was maintained by spontaneous ventilation with 70% nitrous oxide and 0.5% halothane in oxygen. Arterial pressure and heart rate were monitored by automatic oscillotonometer. Stroke volume was measured by two-dimensional echocardiography and pulse Doppler. Measurements were made before induction and at 1-min intervals for 5 min after induction. The reduction in mean arterial pressure was significantly greater after propofol (28-31%) than after thiopentone (14-21%) (P = 0.001). The reduction in cardiac index (10-15%) after induction was not significantly different between the two agents (P = 0.122). Baroreflex mediated increases in heart rate and systemic vascular resistance were less after propofol than after thiopentone. The baroreceptor reflex was more attenuated in children aged less than 2 yr than in older children.