Comparison of the feasibility of different anesthetic induction regimens in cardiac surgery in children with tetralogy of fallot
YIN Yan
ZHANG Rui-dong
LI Shu-wen
OUYANG Chuan
LU Jia-kai
CHENG Wei-ping
Abstract：Objective To evaluate the effect and safety of different anesthetic induction regimens in children with tetralogy of fallot (TOF) during cardiac surgery.Methods Ninety-two TOF patients [American society of anesthesiologists(ASA) Ⅱ-Ⅲ,aged 6 months-3 old years,weighing 5.8-14 kg],were randomly assigned to three groups.Following patients received ketamine 5 mg/kg intramuscular injection in group A (n =31),patients inhaled 8％ sevoflurane in group B (n =31),both groups were given intravenously sufentanil 1 μg/kg and cis-atracurium 0.15 mg/kg when patients had fallen asleep.Individually,patients in group C (n =30) received midazolam 0.1 mg/kg,sufentanil 2 μg/kg and cis-atracurium 0.15 mg/kg intravenously.After arterial cannulation and intubation,sevoflurane-air-oxygen inhalation combinated with sufentanil 1 μg/(kg · h),cis-atracurium 100 μg/(kg · h),propofol 4 mg/kg continously intravenous injection were used to anesthetic maintenance.Vital signs of patients were recorded before anesthesia (T1),after intravenous administration (T2),after intubation (T3).Respectively,arterial blood gas was analyzed after arterial cannulation (T4),30 minutes after mechanical ventilation (T5).Results Heart rate,systolic pressure,dystolic pressure of all patients at T2 and T3 were significantly lower than those at T1 (P ＜ 0.05),pulse oxygen saturation (SpO2) incresed conversely (P ＜ 0.05).Heart,systolic blood pressure,diastolic blood pressure of patients in group C at T2,T3 were lower than those of patients in group A and group B [T2:(128 ± 18)times/min vs (143 ± 17),(142 ±21)times/min,(90 ± 19)mm Hg(1 mm Hg=0.133 kPa)vs (95 ± 18),(97 ± 14)mm Hg,(52 ± 14)mm Hg vs (55 ±22),(54 ± 18)mm Hg; T3:(118 ± 23) times/min vs (137 ± 20),(133 ± 24) times/min,(85 ± 17) mm Hg vs (94 ± 17),(94 ± 19) mm Hg,(47 ± 15) mm Hg vs (53 ± 18),(51 ± 16)mm Hg; all P ＜0.05],but there was no SpO2 difference among three groups(P ＞0.05).Arterial oxygen saturation at T5 got more significant improvement than at T4 in 3 groups [group A:(94 ± 15)％ vs(88 ±14)％; group B:(92 ±12)％ vs (88 ±16)％; group C(91 ±15)％ vs (86 ±14)％; P＜0.05].Conclusions It seems that induction with ketamine and sevoflurane and large dose of sufentanil have no significant adverse effects on hemodynamics and oxygen saturation in TOF patients.Therefore,these three programs are able to apply to anesthetic induction in TOF cardiac surgery.
Keywords：Tetralogy of fallotCardiacAnesthesia
Publication Date：2013-01-01
Online Publishing Date：2026-09-14(First online date of this platform, not the publication date of the document)
Pages：3( 1226-1228 )