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British Journal of Anaesthesia, 1992, Vol. 69, No. 4 356-362
© 1992 The Board of Management and Trustees of the British Journal of Anaesthesia


research-article

EEG BURST SUPPRESSION WITH PROPOFOL DURING CARDIOPULMONARY BYPASS IN CHILDREN: A STUDY OF THE HAEMODYNAMIC, METABOLIC AND ENDOCRINE EFFECTS

G. J. A. LAYCOCK, F.R.C.ANAES., D.C.H., D.R.C.O.G., J. M. MITCHELL, F.R.C.S.*, R. D. PATON, PH.D., S. F. O'B. DONAGHEY, PH.D, R. W. LOGAN, F.R.C.P.(GLAS.)., F.R.C.PATH. and N. S. MORTON, F.R.C.ANAES.

Department of Anaesthetics Yorkhill, Glasgow G3 8SJ
Department of Cardiac Surgery Yorkhill, Glasgow G3 8SJ
Department of Biochemistry Yorkhill, Glasgow G3 8SJ
Royal Hospital for Sick Children Yorkhill, Glasgow G3 8SJ

Correspondence to N.S.M.

We have studied the effects of propofol, given to maintain EEG suppression throughout cardiopulmonary bypass (CPB), in 20 children aged 1-15 yr, in a parallel group comparison. Anaesthesia was produced by fentanyl 50µg kg–1, enflurane or halothane and midazolam 0.1 mg kg–1 at the start of CPB. After randomization, 50% of the children also received propofol during CPB. All children were cooled during CPB (25–28 °C) and pump flows (non-pulsatile) were 2.4 litre min–1 m–2, reducing to 1.2–1.6 litre min–1 m–2 during hypothermia. Large rates of infusion of propofol were required to maintain EEG suppression, particularly during rewarming. Compared with control, the propofol group showed significant increases in mixed venous oxygen saturation and significant reductions in systemic oxygen uptake and glucose and cortisol concentrations. There were no differences in triiodothyronine and lactate concentrations, mean arterial pressure during CPB and inotrope requirement after CPB, or in recovery times.

*Present address: Department of Cardiac Surgery, Killingbeck Hospital, York Road, Leeds LSI4 6UQ.


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