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October 1, 2003Regional Anesthesia & Pain Medicine

Comparison of heart rate response to an epinephrine test dose and painful stimulus in children during sevoflurane anesthesia: heart rate variability and beat-to-beat analysis

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Why the study?

Can heart rate variability and beat-to-beat analysis distinguish the heart rate response to an intravenous epinephrine test dose from a painful stimulus in children during sevoflurane anesthesia?

Population

30 American Society of Anesthesiologists physical status I children requiring elective surgery, median age…

Comparison

Intravenous administration of 0.5 microg/kg of… vs Small skin surgical incision at 1 MAC of…

Design

Other

Authors

ÉWÉric WodeyInserm

Discussion

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Implication

May aid test-dose interpretation under sevoflurane in children; hypothesis-generating and requires prospective validation before practice change.

Structured PICO

Can heart rate variability and beat-to-beat analysis distinguish the heart rate response to an intravenous epinephrine test dose from a painful stimulus in children during sevoflurane anesthesia?

P
Population
30 American Society of Anesthesiologists physical status I children requiring elective surgery, median age 3.5 years, median weight 16 kg.
I
Intervention
Intravenous administration of 0.5 microg/kg of epinephrine at 1 MAC of sevoflurane.
C
Comparator
Small skin surgical incision (painful stimulus) at 1 MAC of sevoflurane.
O
Outcome
Distinguishing the effect on heart rate by intravascular epinephrine infusion versus painful stimulus using heart rate variability and beat-to-beat analysis.surrogate

A secondary decrease in heart rate 60 seconds after the initial change can reliably distinguish an intravascular epinephrine test dose from a painful stimulus in children under sevoflurane anesthesia.

Cite This Study

Éric Wodey (2003) studied this question.

synapsesocial.com/papers/6a7c46a5d501feb4353be608https://doi.org/10.1016/s1098-7339(03)00220-7
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Efficacy of an Epidural Test Dose in Children Anesthetized with Halothane1990 · 121 citations
  2. 2Caudal Epidural Block: A Review of Test Dosing and Recognition of Systemic Injection in Children2001 · 94 citations
  3. 3Anesthesia-related Cardiac Arrest in Children2000 · 493 citations
  4. 4Changes in Electroencephalogram and Autonomic Cardiovascular Activity during Induction of Anesthesia with Sevoflurane Compared with Halothane in Children1999 · 166 citations
  5. 5Heart Rate Variability1996 · 17,209 citations