Impact of sevoflurane anesthesia on brain oxygenation in children younger than 2 years
Impact of sevoflurane anesthesia on brain oxygenation in children younger than 2 years
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DOI：
10.1111/pan.12397
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发表时间：
2014-07-01
影响因子：
1.7
通讯作者：
Chassard, Dominique
中科院分区：
文献类型：
--
作者：
Rhondali, Ossam;Juhel, Simon;Chassard, Dominique
Objective/Aim To assess the impact of sevoflurane and anesthesia-induced hypotension on brain oxygenation in children younger than 2years. Background Inhalational induction with sevoflurane is the most commonly used technique in young children. However, the effect of sevoflurane on cerebral perfusion has been only studied in adults and children older than 1year. The purpose of this study was to assess the impact of sevoflurane anesthesia on brain oxygenation in neonates and infants, using near-infrared spectroscopy. Methods Children younger than 2years, ASA I or II, scheduled for abdominal or orthopedic surgery were included. Induction of anesthesia was started by sevoflurane 6% and maintained with an expired fraction of sevoflurane 3%. Mechanical ventilation was adjusted to maintain an endtidal CO2 around 39mmHg. Brain oxygenation was assessed measuring regional cerebral saturation of oxygen (rSO2c), measured by NIRS while awake and 15min after induction, under anesthesia. Mean arterial pressure (MAP) variation was recorded. Results Hundred and ninety-five children were included. Anesthesia induced a significant decrease in MAP (-27%). rSO2c increased significantly after induction (+18%). Using children age for subgroup analysis, we found that despite MAP reduction, rSO2c increase was significant but smaller in children 6months than in children >6months (6months: rSO2c=+13%, >6months: rSO2c=+22%; P
