Issn Print: 0265-0215

Publication Date: 2005/05/01


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Cardiac arrhythmias during general anesthesia with fentanyl or sevoflurane for cardiac surgery in children: A-550

H. M. Lee; A. Y. Oh; K. S. Seo; H. S. Kim; C. S. Kim

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Background and Goal of Study: We conducted this randomized controlled trial to compare the incidence of arrhythmias during general anesthesia with fentanyl and that with sevoflurane in children undergoing cardiac surgery for atrial or ventricular septal defect (ASD, VSD).
Materials and Methods: 58 patients, aged 1 mo to 12 yr, who were undergoing ASD or VSD repair were enrolled. Holter-ECG recording was started at least 1 hr before the induction of anesthesia and stopped after sternotomy was done. Patients who had preoperative arrhythmias or electrolyte imbalance were ruled out from the study. Without premedication, patients were randomly assigned to sevoflurane (n = 31) or fentanyl (n = 27) group. The sevoflurane group was induced with sevoflurane and vecuronium and the fentanyl group was induced with fentanyl, midazolam, and vecuronium. Each group was maintained with the same agents used in induction of anesthesia under 50% O2 with air. Blood pressure was maintained within 20% of preoperative values in all patients. Chi square test and linear logistic regression analysis are used for statistical analysis and P < 0.05 was considered significant.
Results: The incidence of atrial arrhythmias was not different according to agents used but the incidence of ventricular arrhythmias was significantly higher in sevoflurane group (odds ratio 3.05, 95% confidence interval 1.04-8.92).
Conclusion(s): The overall incidence of cardiac arrhythmias during general anesthesia with fentanyl or sevoflurane was very high in patients with VSD or ASD. The incidence of ventricular arrhythmias was significantly higher in sevoflurane group compared to fentanyl group.

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