Fentanyl intermittent bolus technique for anesthesia in infants and children undergoing cardiac surgery
| Autor: | Gerald L. Becker, E. M. Kennedy, James R. Newland, James W. Chapin, M. Patricia Leuschen, Myrna C. Newland, William F. Fleming, Lynne B. Sarafian, David Lloyd Bolam, Barbara J. Hurlbert |
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| Rok vydání: | 1989 |
| Předmět: |
Heart Defects
Congenital Male medicine.medical_specialty Time Factors Blood Pressure Fentanyl law.invention Electrocardiography Bolus (medicine) law Heart Rate Heart rate medicine Cardiopulmonary bypass Humans Oxygenators Membrane Cardiopulmonary Bypass medicine.diagnostic_test business.industry Infant Surgery Cardiac surgery Anesthesiology and Pain Medicine Blood pressure Anesthesia Child Preschool Anesthetic Injections Intravenous Anesthesia Intravenous Female Cardiology and Cardiovascular Medicine business medicine.drug |
| Zdroj: | Journal of cardiothoracic anesthesia. 3(4) |
| ISSN: | 0888-6296 |
| Popis: | The use of fentanyl by an incremental intravenous (IV) bolus technique was evaluated in eight pediatric patients (ages 4 months to 5 years, ASA III-IV) undergoing corrective surgery for congenital heart defects. Anesthesia was induced with 5 to 10 micrograms/kg of fentanyl. Additional boluses of comparable size were given intermittently thereafter, in order that a total dose of 100 micrograms/kg was achieved just before instituting cardiopulmonary bypass (CPB). Heart rate, systolic blood pressure, various measures of anesthetic depth, and plasma fentanyl levels measured by radioimmunoassay were compared at various points during anesthesia, surgery, and recovery. Decreases in heart rate were observed at the time of sternal incision and at 30 minutes thereafter, when doses of fentanyl were near-maximal. No changes from baseline in systolic blood pressure or in anesthetic depth occurred at any of the intervals studied. The plasma concentration of fentanyl was 30 +/- 8 ng/mL just after completion of the fentanyl administration, immediately before CPB. With onset of CPB, the fentanyl level fell to 13 +/- 9 ng/mL, a statistically significant difference from the baseline value. No further change occurred over the additional 231 +/- 74 minutes in the operating room. The fentanyl concentration was 10 +/- 4 ng/mL upon entry into the recovery room. It is concluded that administration of fentanyl in small, intermittent IV boluses, with dosing completed before the onset of CPB, produces satisfactory plasma levels, anesthesia, and hemodynamic stability in children undergoing corrective surgery for congenital cardiac defects. |
| Databáze: | OpenAIRE |
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