THE PHARMACOLOGY OF SEVOFLURANE IN INFANTS AND CHILDREN
THE PHARMACOLOGY OF SEVOFLURANE IN INFANTS AND CHILDREN
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DOI：
10.1097/00000542-199404000-00014
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发表时间：
1994-04-01
期刊：
影响因子：
8.8
通讯作者：
YENTIS, S
中科院分区：
文献类型：
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作者：
LERMAN, J;SIKICH, N;YENTIS, S
背景：七氟烷是一种新型挥发性麻醉剂，其物理性质适合儿童麻醉。在这项研究中，七氟醚在氧气中的最低肺泡浓度（MAC），在60%的一氧化二氮，血液动力学，诱导和出现反应，七氟醚和无机氟的代谢进行了研究，在90阿萨身体状态1或2新生儿，婴儿，和children.Methods：七氟醚在氧气中的MAC被确定在六组受试者分层，根据年龄：足月新生儿、1-6个月和> 6-12个月的婴儿以及> 1-3岁、> 3-5岁和> 5-12岁的儿童。在一组1-3岁的儿童中测定60%一氧化二氮中的MAC。吸入诱导后，气管插管（新生儿除外，其进行清醒插管）。使用狄克逊的升降技术确定每个年龄组的MAC。结果：新生儿七氟烷的MAC为3.3 +/- 0.2%，1-6个月婴儿的MAC为3.2 +/-0.1%，相似; 6-12个月大婴儿和1-12岁儿童的MAC恒定在约2.5%;在1-3岁儿童中，七氟烷在60%氧化亚氮中的MAC为2.0 +/-0.2%。除1-3岁的儿童和5-12岁的儿童外，所有受试者在切皮前1 MAC时的收缩期动脉压与清醒值相比显著降低，然后在切皮后恢复至清醒值。与所有受试者的清醒值相比，在切开前约1 MAC七氟烷时心率不变，但> 3-5岁和> 5-12岁的儿童除外，他们在切开前心率增加。麻醉诱导，特别是气道刺激性，以及从七氟烷麻醉中苏醒并不显著。无机氟化物的血浆浓度达到最大值（8.8-16.7 μ M）30分钟后，停止麻醉。结论：我们得出结论，七氟烷似乎是一个合适的麻醉剂，用于新生儿，婴儿和儿童进行小于或等于1小时的麻醉。
Background: Sevoflurane is a new volatile anesthetic with physical properties that should make it suitable for anesthesia in children. In this study, the minimum alveolar concentration (MAC) of sevoflurane in oxygen alone and in 60% nitrous oxide, the hemodynamic, induction and emergence responses to sevoflurane and the metabolism to inorganic fluoride were studied in 90 ASA physical status 1 or 2 neonates, infants, and children.Methods: MAC of sevoflurane in oxygen was determined in six groups of subjects stratified according to age: full-term neonates, infants 1-6 and > 6-12 months and children > 1-3, > 3-5 and > 5-12 yr. MAC in 60% nitrous oxide was determined in a separate group of children 1-3 yr of age. After an inhalational induction, the trachea was intubated (except for neonates in whom an awake intubation was performed). MAC for each age group was determined using the Up-and-Down technique of Dixon.Results: MAC of sevoflurane in neonates, 3.3 +/- 0.2% and in infants 1-6 months of age, 3.2 +/- 0.1%, were similar; MAC in older infants 6-12 months and children 1-12 yr was constant at approximate to 2.5%; MAC of sevoflurane in 60% nitrous oxide in children 1-3 yr of age was 2.0 +/- 0.2%. Systolic arterial pressure decreased significantly at 1 MAC before skin incision compared with awake values in all subjects except children 1-3 yr with 60% nitrous oxide and children 5-12 yr in oxygen, and then returned toward awake values after skin incision. Heart rate was unchanged at approximate to 1 MAC sevoflurane before incision compared with awake values in all subjects except children > 3-5 and > 5-12 yr in whom heart rate increased before incision. Induction of anesthesia, particularly with respect to airway irritability, and emergence from sevoflurane anesthesia were not remarkable. The plasma concentration of inorganic fluoride reached maximum values (8.8-16.7 mu M) 30 min after discontinuation of anesthesia.Conclusions: We conclude that sevoflurane appears to be a suitable anesthetic agent for use in neonates, infants and children undergoing less than or equal to 1 h of anesthesia.