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

Jones R.D.M., Visram A.R., Chan M.M.Y., Bacon-Shone J., Mya G.H. and Irwin M.G. (1994) A comparison of three induction agents in paediatric anaesthesia - Cardiovascular effects and recovery. Anaesthesia and Intensive Care, 22 5: 545-555.

Author Jones R.D.M.
Visram A.R.
Chan M.M.Y.
Bacon-Shone J.
Mya G.H.
Irwin M.G.
Title A comparison of three induction agents in paediatric anaesthesia - Cardiovascular effects and recovery
Journal name Anaesthesia and Intensive Care   Check publisher's open access policy
ISSN 0310-057X
Publication date 1994-01-01
Sub-type Article (original research)
Open Access Status Not yet assessed
Volume 22
Issue 5
Start page 545
End page 555
Total pages 11
Language eng
Subject 2703 Anesthesiology and Pain Medicine
Abstract We studied 30 children undergoing circumcision randomly allocated to receive either thiopentone 4 mg.kg, propofol 2.5 mg.kg or midazolam 0.5 mg.kg (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.
Keyword Cardiovascular monitoring
Intravenous anaesthetics
Paediatric anaesthesia
Psychomotor recovery
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Unknown

Document type: Journal Article
Sub-type: Article (original research)
Collection: Scopus Import - Archived
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Citation counts: Scopus Citation Count Cited 18 times in Scopus Article | Citations
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