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Article: A comparison of three induction agents in paediatric anaesthesia - Cardiovascular effects and recovery

TitleA comparison of three induction agents in paediatric anaesthesia - Cardiovascular effects and recovery
Authors
KeywordsCardiovascular monitoring
Intravenous anaesthetics
Midazolam
Paediatric anaesthesia
Propofol
Psychomotor recovery
Thiopentone
Issue Date1994
PublisherAustralian Society of Anaesthetists. The Journal's web site is located at http://www.aaic.net.au
Citation
Anaesthesia And Intensive Care, 1994, v. 22 n. 5, p. 545-555 How to Cite?
AbstractWe studied 30 children undergoing circumcision randomly allocated to receive either thiopentone 4 mg.kg-1, propofol 2.5 mg.kg-1 or midazolam 0.5 mg.kg-1 (n = 10) IV over 30 seconds at induction of anaesthesia. Blood pressure and pulse rate during the first 15 minutes of induction were recorded by a Finapres 2300e and a Cardiocap CM-104, and changes from preinduction baseline compared between the three induction agents and the two recording instruments. Postoperatively, blood levels of the induction agents were measured and recovery from anaesthesia was assessed by clinical criteria, mood and sedation scores and psychomotor performance. The Cardiocap data revealed no statistically significant haemodynamic differences between the three induction agents. Finapres data demonstrated that propofol caused a greater decrease in mean arterial pressure when compared to thiopentone at one minute (P = 0.01) and the MAP remained significantly lower than midazolam at five minutes (P = 0.02), illustrating an advantage of continuous over intermittent non-invasive blood pressure monitoring. The midazolam group took longer to identify themselves compared to both the propofol (P = 0.005) and the thiopentone groups (P = 0.02), but there was no difference in the groups in time to eye-opening. Psychomotor performance on awakening was significantly worse in the midazolam group compared to the propofol (P < 0.03) and thiopentone groups (P < 0.02). Most children had recovered to 80% of their best, practised, unmedicated, preoperative performance four hours after awakening, irrespective of the induction agent administered. Drug blood levels correlated weakly with both methods of psychomotor assessment (r ≥ 0.6). Of the three induction agents, thiopentone caused the least haemodynamic perturbation on induction, and anaesthesia induced with midazolam caused the greatest psychomotor impairment on awakening. Within one hour patients in all drug groups were equally awake, co-operative and co-ordinated.
Persistent Identifierhttp://hdl.handle.net/10722/147166
ISSN
2015 Impact Factor: 1.283
2015 SCImago Journal Rankings: 0.488
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorJones, RDMen_US
dc.contributor.authorVisram, ARen_US
dc.contributor.authorChan, MMYen_US
dc.contributor.authorBaconShone, Jen_US
dc.contributor.authorMya, GHen_US
dc.contributor.authorIrwin, MGen_US
dc.date.accessioned2012-05-29T06:00:31Z-
dc.date.available2012-05-29T06:00:31Z-
dc.date.issued1994en_US
dc.identifier.citationAnaesthesia And Intensive Care, 1994, v. 22 n. 5, p. 545-555en_US
dc.identifier.issn0310-057Xen_US
dc.identifier.urihttp://hdl.handle.net/10722/147166-
dc.description.abstractWe studied 30 children undergoing circumcision randomly allocated to receive either thiopentone 4 mg.kg-1, propofol 2.5 mg.kg-1 or midazolam 0.5 mg.kg-1 (n = 10) IV over 30 seconds at induction of anaesthesia. Blood pressure and pulse rate during the first 15 minutes of induction were recorded by a Finapres 2300e and a Cardiocap CM-104, and changes from preinduction baseline compared between the three induction agents and the two recording instruments. Postoperatively, blood levels of the induction agents were measured and recovery from anaesthesia was assessed by clinical criteria, mood and sedation scores and psychomotor performance. The Cardiocap data revealed no statistically significant haemodynamic differences between the three induction agents. Finapres data demonstrated that propofol caused a greater decrease in mean arterial pressure when compared to thiopentone at one minute (P = 0.01) and the MAP remained significantly lower than midazolam at five minutes (P = 0.02), illustrating an advantage of continuous over intermittent non-invasive blood pressure monitoring. The midazolam group took longer to identify themselves compared to both the propofol (P = 0.005) and the thiopentone groups (P = 0.02), but there was no difference in the groups in time to eye-opening. Psychomotor performance on awakening was significantly worse in the midazolam group compared to the propofol (P < 0.03) and thiopentone groups (P < 0.02). Most children had recovered to 80% of their best, practised, unmedicated, preoperative performance four hours after awakening, irrespective of the induction agent administered. Drug blood levels correlated weakly with both methods of psychomotor assessment (r ≥ 0.6). Of the three induction agents, thiopentone caused the least haemodynamic perturbation on induction, and anaesthesia induced with midazolam caused the greatest psychomotor impairment on awakening. Within one hour patients in all drug groups were equally awake, co-operative and co-ordinated.en_US
dc.languageengen_US
dc.publisherAustralian Society of Anaesthetists. The Journal's web site is located at http://www.aaic.net.auen_US
dc.relation.ispartofAnaesthesia and Intensive Careen_US
dc.subjectCardiovascular monitoring-
dc.subjectIntravenous anaesthetics-
dc.subjectMidazolam-
dc.subjectPaediatric anaesthesia-
dc.subjectPropofol-
dc.subjectPsychomotor recovery-
dc.subjectThiopentone-
dc.subject.meshAffect - Drug Effectsen_US
dc.subject.meshAnesthesia Recovery Perioden_US
dc.subject.meshAnesthesia, Intravenousen_US
dc.subject.meshBlood Pressure - Drug Effectsen_US
dc.subject.meshBlood Pressure Monitorsen_US
dc.subject.meshChilden_US
dc.subject.meshChild, Preschoolen_US
dc.subject.meshCircumcision, Maleen_US
dc.subject.meshConscious Sedationen_US
dc.subject.meshHumansen_US
dc.subject.meshMaleen_US
dc.subject.meshMidazolam - Administration & Dosage - Blood - Pharmacologyen_US
dc.subject.meshMonitoring, Intraoperativeen_US
dc.subject.meshPhimosis - Surgeryen_US
dc.subject.meshPropofol - Administration & Dosage - Blood - Pharmacologyen_US
dc.subject.meshPsychomotor Performance - Drug Effectsen_US
dc.subject.meshPulse - Drug Effectsen_US
dc.subject.meshThiopental - Administration & Dosage - Blood - Pharmacologyen_US
dc.subject.meshTime Factorsen_US
dc.subject.meshWakefulness - Drug Effectsen_US
dc.titleA comparison of three induction agents in paediatric anaesthesia - Cardiovascular effects and recoveryen_US
dc.typeArticleen_US
dc.identifier.emailBaconShone, J:johnbs@hku.hken_US
dc.identifier.emailIrwin, MG:mgirwin@hku.hken_US
dc.identifier.authorityBaconShone, J=rp00056en_US
dc.identifier.authorityIrwin, MG=rp00390en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.pmid7818058-
dc.identifier.scopuseid_2-s2.0-0027946512en_US
dc.identifier.hkuros6063-
dc.identifier.volume22en_US
dc.identifier.issue5en_US
dc.identifier.spage545en_US
dc.identifier.epage555en_US
dc.identifier.isiWOS:A1994PM92700006-
dc.publisher.placeAustraliaen_US
dc.identifier.scopusauthoridJones, RDM=7501542949-
dc.identifier.scopusauthoridVisram, AR=6602931233-
dc.identifier.scopusauthoridChan, MMY=18534095500-
dc.identifier.scopusauthoridBaconShone, J=6602137416-
dc.identifier.scopusauthoridMya, GH=6602928992-
dc.identifier.scopusauthoridIrwin, MG=7202411076-

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