JOURNAL HOME CME HOME THIS MONTH PAST ISSUES ETOC COLLECTIONS
AUTHORS REVIEWERS EDITORIAL BOARD FEEDBACK RSS HELP
A&A International Anesthesia Research Society
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a colleague
Right arrow Similar articles in this journal
Right arrow Similar articles in Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Web of Science (6)
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Laird, T. H.
Right arrow Articles by Andropoulos, D. B.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Laird, T. H.
Right arrow Articles by Andropoulos, D. B.
Related Collections
Right arrow Heart
Right arrow Pediatrics
Right arrow Pharmacology

Anesth Analg 2002;95:1200-1206
© 2002 International Anesthesia Research Society

PEDIATRIC ANESTHESIA

Pulmonary-to-Systemic Blood Flow Ratio Effects of Sevoflurane, Isoflurane, Halothane, and Fentanyl/Midazolam with 100% Oxygen in Children with Congenital Heart Disease

Tracy H. Laird, MD*, Stephen A. Stayer, MD{dagger}, Shannon M. Rivenes, MD*, Mark B. Lewin, MD§, E. Dean McKenzie, MD{ddagger}, Charles D. Fraser, MD{ddagger}, and Dean B. Andropoulos, MD{dagger}

Divisions of *Pediatric Cardiology, {dagger}Pediatric Cardiovascular Anesthesiology, and {ddagger}Congential Heart Surgery, Texas Children’s Hospital and Baylor College of Medicine, Houston; and §Division of Pediatric Cardiology, Children’s Hospital and Regional Medical Center and the University of Washington School of Medicine, Seattle, Washington

Address correspondence and reprint requests to Dean B. Andropoulos, MD, Division of Pediatric Cardiovascular Anesthesiology, Texas Children’s Hospital, 6621 Fannin, WT 19345H, Houston, TX 77030-2399. Address e-mail to dra{at}bcm.tmc.edu

The cardiovascular effects of volatile anesthetics in children with congenital heart disease have been studied, but there are limited data on the effects of anesthetics on pulmonary-to-systemic blood flow ratio (Qp:Qs) in patients with intracardiac shunting. In this study, we compared the effects of halothane, isoflurane, sevoflurane, and fentanyl/midazolam on Qp:Qs and myocardial contractility in patients with atrial (ASD) or ventricular (VSD) septal defects. Forty patients younger than 14 yr old scheduled to undergo repair of ASD or VSD were randomized to receive halothane, sevoflurane, isoflurane, or fentanyl/midazolam. Cardiovascular and echocardiographic data were recorded at baseline, randomly ordered 1 and 1.5 mean alveolar anesthetic concentration (MAC) levels, or predicted equivalent fentanyl/midazolam plasma levels. Ejection fraction (using the modified Simpson’s rule) was calculated. Systemic (Qs) and pulmonary (Qp) blood flow was echocardiographically assessed by the velocity-time integral method. Qp:Qs was not significantly affected by any of the four regimens at either anesthetic level. Left ventricular systolic function was mildly depressed by isoflurane and sevoflurane at 1.5 MAC and depressed by halothane at 1 and 1.5 MAC. Sevoflurane, halothane, isoflurane, or fentanyl/midazolam in 1 or 1.5 MAC concentrations or their equivalent do not change Qp:Qs in patients with isolated ASD or VSD.

IMPLICATIONS: Sevoflurane, halothane, isoflurane, and fentanyl/midazolam do not change pulmonary-to-systemic blood flow ratio in children with atrial and ventricular septal defects when administered at standard anesthetic doses with 100% oxygen.




This article has been cited by other articles:


Home page
 Anesth. Analg.Home page
G. D. Williams, B. M. Philip, L. F. Chu, M. G. Boltz, K. Kamra, H. Terwey, G. B. Hammer, S. B. Perry, J. A. Feinstein, and C. Ramamoorthy
Ketamine Does Not Increase Pulmonary Vascular Resistance in Children with Pulmonary Hypertension Undergoing Sevoflurane Anesthesia and Spontaneous Ventilation
Anesth. Analg., December 1, 2007; 105(6): 1578 - 1584.
[Abstract] [Full Text] [PDF]

Home page
 Br J AnaesthHome page
A. T. Lovell
Anaesthetic implications of grown-up congenital heart disease
Br. J. Anaesth., July 1, 2004; 93(1): 129 - 139.
[Abstract] [Full Text] [PDF]

Home page
 SEMIN CARDIOTHORAC VASC ANESTHHome page
R. Yumul, A. Emdadi, and N. Moradi
Anesthesia for Noncardiac Surgery in Children with Congenital Heart Disease
Seminars in Cardiothoracic and Vascular Anesthesia, June 1, 2003; 7(2): 153 - 165.
[Abstract] [PDF]


Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2002 by the International Anesthesia Research Society.