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Changes in cerebral blood flow velocity in children during sevoflurane and halothane anesthesia
R A Berkowitz1, W E Hoffman, F Cunningham
1Anesthesiology Department, University of Illinois at Chicago 60612, USA.
Insights
Sevoflurane and halothane anesthesia in children both lower blood pressure and increase cerebral blood flow velocity. Sevoflurane demonstrates similar cerebrovascular effects to halothane during anesthetic induction.
Area of Science:
- Anesthesiology
- Pediatric Anesthesia
- Cerebrovascular Physiology
Background:
- Anesthetic agents impact cerebral hemodynamics.
- Understanding these effects is crucial for patient safety during pediatric anesthesia.
Purpose of the Study:
- To compare arterial blood pressure and middle cerebral artery blood flow velocity in children during sevoflurane anesthesia induction.
- To compare these measures with those from a halothane anesthesia control group.
Main Methods:
- Pediatric patients underwent mask induction with sevoflurane or halothane and 70% nitrous oxide.
- Arterial blood pressure was measured using oscillometric technique.
- Middle cerebral artery blood flow velocity was assessed via transcranial Doppler ultrasonography.
Main Results:
- Both sevoflurane and halothane, combined with nitrous oxide, reduced blood pressure and increased cerebral blood flow velocity.
- Endotracheal intubation transiently increased blood pressure and further elevated cerebral blood flow velocity.
Conclusions:
- Sevoflurane and halothane, when used with nitrous oxide, induce comparable decreases in blood pressure and increases in cerebral blood flow velocity.
- Sevoflurane exhibits similar cerebrovascular effects to halothane during pediatric anesthetic induction.
Abstract:
The purpose of this study was to evaluate arterial blood pressure and middle cerebral artery blood flow velocity in children during induction of anesthesia with sevoflurane. These measures were compared to findings in a control group anesthetized with halothane. Each child received mask induction of sevoflurane (n = 9) or halothane (n = 9) with 70% nitrous oxide in oxygen. Blood pressure was measured noninvasively by an oscillometric technique using a Dinamap. Blood flow velocity was measured using a transcranial Doppler with a 2-MHz probe. End-tidal CO2, nitrous oxide, and anesthetic concentrations were measured by a Datex Ultima Capnomac. Both sevoflurane (2.4%) and halothane (1.3%) combined with 70% nitrous oxide decreased blood pressure and increased cerebral blood flow velocity. Intubation increased blood pressure and further increased cerebral blood flow velocity with both anesthetic treatments. These results indicate that sevoflurane and halothane combined with nitrous oxide decrease blood pressure and increase cerebral blood flow velocity and suggest that sevoflurane produces cerebrovascular effects similar to those of halothane during anesthetic induction.