Effects of various intravenous anesthetics on acid-base balance in children and some clinical observations
Nakahashi, R.; Baba, Y.; Maeda, A.
Masui. Japanese Journal of Anesthesiology 24(9): 880-885
1975
ISSN/ISBN: 0021-4892 PMID: 1238586 Document Number: 83865
This study was intended to clarify the effects of several i.v. anesthetics on acid-base balance in 32 infants and children aging from 9 mo. to 10 yr. Clinical observations were made at the same time. Severe metabolic acidosis occurred following propanidid anesthesia. In this group mean value of the base excess changed from -3.8 meq/l at the induction of anesthesia to -7.9 meq/l at 60 min after the beginning of anesthesia in spite of PaCO2 [arterial CO2 tension] being maintained within normal ranges. With other i.v. anesthetics, no such deleterious effect on acid-base balance was encountered. Althesin was given by i.v. drip infusion (0.012 ml/kg per min) in 7 children. The onset of action of althesin was very rapid, i.e., the induction time from the injection of althesin to the loss of consciousness was within about 30 s in children. There was a transient fall in blood pressure and an increase in pulse rate following induction with althesin. In the period of recovery from anesthesia, excitement probably due to anti-analgesic action of althesin was observed in almost all cases. Pentazocine was very effective against the excitement. Propanidid was also an excellent i.v. agent for induction of anesthesia but its use as an agent of maintenance may cause severe adverse troubles. Most of the patients in the propanidid group showed pale skin and excitation in the period of recovery from anesthesia. In the filed of pediatric anesthesia, ketamine is one of the most recommended agents for induction of anesthesia, because it can be injected i.m. and its action appears rapidly and smoothly, but when it is applied for long cases, many troubles are apt to be observed in the recovery period. Neuroleptanesthesia using droperidol and pentazocine was performed in 7 children aged 2-8 yr. Respiratory depression was observed, but the circulatory state was stable. The patients complained of less incisional pain in the post operative period.