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An observational study of the macro‐ and micro‐haemodynamic implications of epidural anaesthesia in children
Author(s) -
Triffterer L.,
Marhofer P.,
Lechner G.,
Marksz T. C.,
Kimberger O.,
Schmid W.,
Marhofer D.
Publication year - 2017
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1111/anae.13746
Subject(s) - medicine , stroke volume , anesthesia , hemodynamics , cardiac output , vascular resistance , blood pressure , mean arterial pressure , heart rate , stroke (engine) , oxygenation , blood volume , cardiology , mechanical engineering , engineering
Summary The haemodynamic implications of epidural anaesthesia in children are poorly documented. We report macro‐ and micro‐haemodynamic data from an observational study of 25 children ranging from neonates to six‐years old, who underwent surgery conducted with a specific combination of monitoring systems. We analysed 90 min of study‐related monitoring after epidural catheterisation, with skin incision taking place after around 30 min. We recorded macrohaemodynamic parameters (monitored using Li DCO rapid ) including heart rate, mean arterial pressure, cardiac output, stroke volume, systemic vascular resistance and stroke volume variation. Microhaemodynamic parameters (monitored using Invos™) included cerebral and peri‐renal oxygenation. Based on the entire 90 min of study‐related monitoring, we found significant increases in cardiac output (p = 0.009), stroke volume (p = 0.006) and stroke volume variation (p = 0.008), as well as decreases in systemic vascular resistance (p = 0.007) around 30 min after epidural blockade. There were no significant changes in heart rate, arterial pressure and cerebral or peri‐renal oxygenation during these 90 min. Considering that the microhaemodynamic parameters were not affected by the macrohaemodynamic changes, we conclude that autoregulation of the brain and the kidneys was maintained in children under epidural anaesthesia.