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British Journal of Anaesthesia, 2003, Vol. 90, No. 5 636-641
© 2003 The Board of Management and Trustees of the British Journal of Anaesthesia

Clinical Investigations

Cerebral autoregulation in children during sevoflurane anaesthesia{dagger}

M. S. Vavilala1,2, L. A. Lee1, M. Lee1, A. Graham2, E. Visco1 and A. M. Lam1,3

1 Department of Anesthesiology, 2 Department of Pediatrics and 3 Department of Neurological Surgery, University of Washington, Seattle, WA 98104, USA

{dagger}This work was presented, in part, as an abstract at the Society of Neurological Anesthesia and Critical Care Society Meeting, 13 October 2000, in San Francisco, CA.

Introduction. Little is known about cerebral autoregulation in children. The aim of this study was to examine cerebral autoregulation in children.

Methods. Cerebral autoregulation testing was performed during less than 1 MAC sevoflurane anaesthesia in children (from 6 months to 14 yr) and in adults (18–41 yr). Mean middle cerebral artery flow velocities (VMCA) were measured using transcranial Doppler ultrasonography. Mean arterial pressure (MAP) was increased to whichever was greater: 20% above baseline or (i) 80 mm Hg for less than 9 yr, (ii) 90 mm Hg for 9–14 yr, and (iii) 100 mm Hg for adults. Cerebral autoregulation was considered intact if the autoregulatory index was >=0.4.

Results. There were 13 subjects less than 2 yr old (Group 1), 13 subjects 2–5 yr (Group II), 14 subjects 6–9 yr (Group III), 12 subjects 10–14 yr (Group IV), and 12 adults (Group V; control group). All subjects had an autoregulatory index >=0.4. There was no difference in autoregulatory index between children in Groups I–IV or between children and adults.

Discussion. We found no age-related differences in autoregulatory capacity during low-dose sevoflurane anaesthesia. We report no differences in autoregulatory capacity between children and adults.

Br J Anaesth 2003; 90: 636–41


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