Blood pressure control by sevoflurane administration during pediatric cardiopulmonary bypass

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  • 血管拡張薬としてのセボフルラン
  • ―小児体外循環中の使用経験―

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We have used sevoflurane(SEV)as a vasodilator during the pediatric cardio pulmonary bypass(CPB)from July 2010. The usefulness of the SEV as a vasodilator was investigated.<br>Eighteen infants under 7.5kg undergoing CPB were included. During aorta cross clamping, pump flow was maintained at 2.7L/min/m2 and mean systemic blood pleasure(SBP)was maintained at 35-55mmHg. If SBP exceeds 55mmHg, we used some vasodilators. By two vasodilator strategy, we compared group S(SEV: n=8)and group C(Control: n=10). In group S, SEV(0.5-2.0%)was administrated 25±16min after starting CPB as a main vasodilator. In C group, SBP was controlled at only 1-3mg bolus infusion of chlorpromazine.<br>Total amount of chlorpromazine was lower in group S(2±1mg)than in group C(9±4mg)(P<0.01). Although, in group C, there was no difference in SBP between at the start of CPZ and at the after 15min(56±11, 52±11mmHg), in group S, SBP was significantly decreased at the after 15min than at the start of SEV(58±6, 40±10mmHg)(P<0.01), and SBP was stabilized after that(after 20 min, 42±9mmHg). Furthermore, urine output during CPB was more in group S(206±113mL)than group C(86±93mL)(P=0.02).<br>By SEV administration as a vasodilator during pediatric CPB, not only rapid vasodilation but also maintenance of urine output were obtained, therefore SEV is an useful option as a vasodilator during pediatric CPB.

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