Sevoflurane induction in cyanotic and acyanotic children with congenital heart disease

Abstract

The aim of the study was to investigate the induction characteristics of sevoflurane in cyanotic and acyanotic children with congenital heart disease compared with healthy controls in a prospective, controlled, non-blinded study at a university hospital. After placement of standard noninvasive monitors, inhaled induction of anaesthesia was achieved via a facemask by using 7% sevoflurane in 100% oxygen, in all 3 groups (control group, n = 16; acyanotic group, n = 32; cyanotic group, n = 30). Three minutes after induction, tracheal intubation was performed without a muscle relaxant. In each case, the time from mask application to loss of eyelash reflex and to centralisation of the pupils, heart rate, blood pressure and oxygen saturation was recorded. After intubation, intubating conditions were graded and incidences of airway obstruction recorded. The demographic data was similar between the 3 groups except for the sex ratio in Group 1 compared with the other groups (P = 0.005). The durations to loss of eyelash reflex were found to be significant between the patients with acyanotic and cyanotic heart disease (P = 0.044). Centralisation of the pupils, heart rate and blood pressure results, as well as the incidences of airway obstruction and intubation conditions, were similar between the groups (P > 0.05). In addition, oxygen saturation was significantly lower in the cyanotic group at all stages (P < 0.01). Induction characteristics of sevoflurane in cyanotic and acyanotic children with congenital heart disease and in healthy children are similar. Sevoflurane induction is an effective and well-tolerated technique for cyanotic and acyanotic children with congenital heart disease.