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British Journal of Anaesthesia, 2002, Vol. 88, No. 3 357-361
© 2002 The Board of Management and Trustees of the British Journal of Anaesthesia

Clinical Investigations

Cerebrovascular carbon dioxide reactivity in children anaesthetized with sevoflurane

D. A. Rowney*, R. Fairgrieve and B. Bissonnette

Department of Anaesthesia, The Hospital for Sick Children, University of Toronto, Ontario, Canada, M5G 1X8 *Corresponding author: Department of Anaesthesia, Royal Hospital for Sick Children, Sciennes Road, Edinburgh EH9 1LF, UK

Background. To determine the effects of sevoflurane on cerebrovascular carbon dioxide reactivity (CCO2R), middle cerebral artery blood flow velocity (CBFV) was measured at different levels of PE'CO2 by transcranial Doppler sonography in 16 ASA I or II children, aged 18 months to 7 yr undergoing elective urological surgery.

Methods. Anaesthesia comprised 1.0 MAC sevoflurane and air in 30% oxygen delivered through an Ayre’s T piece by intermittent positive-pressure ventilation, and a caudal epidural block with 0.25% bupivacaine 1.0 ml kg–1 without epinephrine. PE'CO2 was randomly adjusted to 25, 35, 45 and 55 mm Hg (3.3, 4.6, 5.9 and 7.2 kPa) with an exogenous source of CO2, while maintaining ventilation variables constant.

Results. CBFV increased as PE'CO2 increased from 25 to 35, and to 45 mm Hg (P<0.001), but did not increase significantly with an increase in PE'CO2 from 45 to 55 mm Hg. Mean heart rate and arterial pressure remained constant.

Conclusion. CCO2R is preserved in healthy children anaesthetized with 1.0 MAC sevoflurane.

Br J Anaesth 2002; 88: 357–61


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