Author(s)

Suruchi Hasija^1*, Sandeep Chauhan¹, Neeti Makhija¹, Sarvesh Pal Singh¹, Sanjay Kumar¹, Arin Choudhury¹, Sachin Talwar², Usha Kiran¹

¹Department of Cardiac Anaesthesiolgy, All India Institute of Medical Sciences, New Delhi, India.
²Department of Cardiothoracic and Vascular Surgery, All India Institute of Medical Sciences, New Delhi, India.

Objective: To compare the haemodynamic effects of the induction agents ketamine, etomidate and sevoflurane using the model of electrical velocimetry based cardiac output monitoring in paediatric cardiac surgical patients. Design: Prospective randomized study. Setting: Tertiary care hospital. Participants: 60 children < 2 years age undergoing cardiac surgery. Interventions: The patients were randomized into 3 equal groups to receive 1.5-2.5 mg/kg iv ketamine (group K), 0.2-0.3 mg/kg iv etomidate (group E) or upto 8% sevoflurane (group S) as the induction agent. Hemodynamic parameters were noted before and after induction of anaesthesia utilizing a noninvasive cardiac monitor based on the model of electrical velocimetry. Measurements and Main Results: The demographic characteristics of the patients were similar in the three groups. The HR decreased in all groups, least in group E (P ≤ 0.01) but the MAP decreased only in group S (P ≤ 0.001). In group S, the stroke volume improved from 9 ± 3.2 ml to 10 ± 3.2 ml (P ≤ 0.05) and the stroke volume variation decreased from 25% ± 6.4% to 13% ± 6.2% (P ≤ 0.001). The stroke index and systemic arterial saturation improved in all groups (P ≤ 0.01). The cardiac index and index of contractility were unchanged. The transthoracic fluid content reduced in groups E and S, but did not change in group K (P ≤ 0.05). Conclusions: Etomidate appeared to provide the most stable conditions for induction of anesthesia in children undergoing cardiac surgery, followed by ketamine and sevoflurane.

Anesthesia Induction Agents, Electrical Velocimetry, Noninvasive Hemodynamic Monitoring, Pediatric Cardiac Surgery

Hasija, S. , Chauhan, S. , Makhija, N. , Singh, S. , Kumar, S. , Choudhury, A. , Talwar, S. and Kiran, U. (2014) Comparison of the Hemodynamic Effects of the Induction Agents Ketamine, Etomidate and Sevoflurane Using the Model of Electrical Velocimetry Based Cardiac Output Monitoring in Pediatric Cardiac Surgical Patients. World Journal of Cardiovascular Surgery, 4, 167-175. doi: 10.4236/wjcs.2014.410024.