Abstract
Thirty patients aged 1–23 mth received either alfentanil or fentanyl for the induction and maintenance of IV sedation during cardiac catheterization following oral flunitrazepam premedication (0.1 mg · kg−1). Patients breathed spontaneously 30 per cent oxygen in air. Both alfentanil and fentanyl abolished all reaction to pain and discomfort with minimal haemodynamic and respiratory changes. Induction doses of alfentanil and fentanyl were 20 ± 6 and 2.5 ± 1.1 (mean ± SD) μg · kg−1, respectively, and maintenance requirements 30 ± 12 and 1.5 ± 0.6 μg · kg−1 · h−1, respectively. These requirements were comparable among younger and older as well as cyanotic and acyanotic patients. The TV sedation described adds an effective method to the armamentarium of an anaesthetist working in the cardiac laboratory.
Résumé
Trente patients âgés de 1 à 23 mois ont reçu soit de l’alfentanil soit du fentanyl pour l’induction et le maintien de la sédation intraveineuse durant le cathétérisme cardiaque après une prémédication au flunitrazépam (0,1 mg · kg−1). Les patients respiraient spontanément 30 pour cent d’oxygène dans l’air. L’alfentanil el le fentanyl ont aboli la rèaction et la douleur avec des changements minimes tant hémodynamiques que respiratoires. Les doses d induction d’alfentanil et de fentanyl étaient respectivement 20 ± 6 et 2,5 ± 1,1 (moyenne ± SD) μg · kg−1, respectivement, et les doses de maintien étaient 30 ± 12 et 1,5 ± 0.6 μg · kg−1 · hres−1, respectivement. Ces doses étaient comparables chez les jeunes et les moins jeunes ainsi que chez les patients présentant une cyanose ou ceux qui étaient acyanotiques. La sédation intraveineuse décrite ajoute une méthode efficace à l’armatorium de l’anesthésiste ceuvrant dans le laboratoire de cardiologie.
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Hickey PR, Wessel DL. Anesthesia in the pediatric cardiac catheterization laboratory.In: Kaplan JA (Ed.). Cardiac Anesthesia, 2nd ed., Orlando: Grune & Stratton Inc., 1987; 2: 664.
Ruckman RN, Keane JF, Freed MD, Ellison RC, Waldman JD. Sedation for cardiac catheterization. A controlled study. Pediatr Cardiol 1980; 1: 263–8.
Malviya S, Burrows SA, Johnston AE, Benson LE. Anaesthetic experience with paediatric interventional cardiology. Can J Anaesth 1989; 36: 320–4.
Freed MD. Cardiac catheterization.In: Adams FH, Emmanouilides GC, Riemenschneider TA (Eds.). Moss’ Heart Disease in Infants, Children, and Adolescents, 4th ed., Baltimore: Williams & Wilkins, 1989; 130–47.
Litchfield JT, Wilcoxon F. A simplified method of evaluating dose-effect experiments. J Pharmacol Exp Ther 1949; 53: 99–113.
Ausems ME, Hug C Jr,Stanski DR, Burm ACL. Plasma concentrations of alfentanil required to supplement nitrous oxide anesthesia for general surgery. Anesthesiology 1986; 65: 362–73.
Bailey PL, Stanski TH. Pharmacology of intravenous narcotic anesthetics. In: Miller RD (Ed.). Anesthesia, 2nd ed., New York: Churchill Livingstone, 1986; 1: 757.
Stanski DR, Hug CC Jr. Alfentanil — a kinetically predictable narcotic analgesic. Anesthesiology 1982; 57: 435–8.
O’Connor M, Escarpa A, Prys-Roberts C. Ventilatory depression during and after infusion of alfentanil in man. Br J Anaesth 1983; 55 (suppl 2): 217–22.
Scott JC, Ponganis KV, Stanski DR. EEG quantitation of narcotic effect: the comparative pharmacodynamics of fentanyl and alfentanil. Anesthesiology 1985; 62: 234–41.
Roure P, Jean N, Leclerc AC, Cabanel N, Levron JC, Duvaldestin P. Pharmacokinetics of alfentanil in children undergoing surgery. Br J Anaesth 1987; 59: 1437–40.
Goresky GV, Koren G, Sabourin MA, Sale JP, Strunin L. The pharmacokinetics of alfentanil in children. Anesthesiology 1987; 67: 654–9.
d’Hollander JM, Hennis PJ, Burm AGL, Bovill JG. Alfentanil in infants and children with congenital heart defects. J Cardiothor Anesth 1988; 2: 12–7.
Koren G, Goresky G, Crean P, Klein J, MacLeod SM. Pediatric fentanyl dosing based on pharmacokinetics during cardiac surgery. Anesth Analg 1984; 63: 577–82.
Yates AP, Lindahl SGE, Hatch DJ. Pulmonary ventilation and gas exchange before and after correction of congenital cardiac malformations. Br J Anaesth 1987; 59: 170–8.
Weiner IM, Mudge GH. Diuretics and other agents employed in the mobilization of edema fluid.In: Gilman AG, Goodman LS, Rail TW, Murad F (Eds.). The Pharmacological Basis of Therapeutics, 7th ed., New York: MacMillan Publishing Co., 1985: 897.
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The financial support given by the Paulo Foundation, Helsinki, is kindly recognized.
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Meretoja, O.A., Rautiainen, P. Alfentanil and fentanyl sedation in infants and small children during cardiac catheterization. Can J Anaesth 37, 624–628 (1990). https://doi.org/10.1007/BF03006479
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DOI: https://doi.org/10.1007/BF03006479