Trendelenburg positioning does not prevent a decrease in cardiac output after induction of anaesthesia with propofol in children

A. Kardos, C. Földesi, A. Nagy, A. Sáringer, A. Kiss, G. Kiss, P. Marschalkó, M. Szabó

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Background and objective: Induction of anaesthesia may cause decreased cardiac output and blood pressure. Head-down tilt is often the first clinical step to treat hypotension. The objective of this randomized single centre study was to determine, with the use of impedance cardiography (ICG), whether Trendelenburg positioning modifies the haemodynamic response to propofol/ fentanyl induction of anaesthesia in ASA I children. Methods: Thirty ASA I children aged between 7 and 16 years scheduled for elective minor orthopaedic surgery were included. After intravenous induction with propofol and fentanyl in the head-down group (HDG, n = 15), 5 min of 20° head-down tilt was applied. In the supine group (SG, n = 15), no change in the supine position was made. Heart rate (HR), mean arterial blood pressure (MABP), end-tidal carbon dioxide (ETCO2), stroke volume index (SVI), cardiac index (CI), systemic vascular resistance index (SVRI) and Heather index (HI) were recorded before (B), at 3 (A3), 5 (A5) and 8 (A8) minutes after induction in each group. Results: After induction, a significant decrease in CI, MABP, HR and HI was recorded in both groups. In the study group, significantly lower values of HR (66 vs. 78 beat/min) and higher values of SVI (42.9 vs. 40.6 ml/min/m2) were measured at A3 compared with the control group. After induction, no difference in CI and SVRI was found between the two groups. Conclusion: The present study shows that cardiac performance is not improved by Trendelenburg positioning after propofol/fentanyl induction of anaesthesia in children.

Original languageEnglish
Pages (from-to)869-874
Number of pages6
JournalActa Anaesthesiologica Scandinavica
Volume50
Issue number7
DOIs
Publication statusPublished - Aug 2006

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Propofol
Cardiac Output
Arterial Pressure
Fentanyl
Anesthesia
Head-Down Tilt
Heart Rate
Vascular Resistance
Stroke Volume
Impedance Cardiography
Minor Surgical Procedures
Supine Position
Carbon Dioxide
Hypotension
Orthopedics
Hemodynamics
Head
Blood Pressure
Control Groups

Keywords

  • Cardiac output
  • Impedance cardiography
  • Pediatric
  • Trendelenburg position

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Trendelenburg positioning does not prevent a decrease in cardiac output after induction of anaesthesia with propofol in children. / Kardos, A.; Földesi, C.; Nagy, A.; Sáringer, A.; Kiss, A.; Kiss, G.; Marschalkó, P.; Szabó, M.

In: Acta Anaesthesiologica Scandinavica, Vol. 50, No. 7, 08.2006, p. 869-874.

Research output: Contribution to journalArticle

Kardos, A. ; Földesi, C. ; Nagy, A. ; Sáringer, A. ; Kiss, A. ; Kiss, G. ; Marschalkó, P. ; Szabó, M. / Trendelenburg positioning does not prevent a decrease in cardiac output after induction of anaesthesia with propofol in children. In: Acta Anaesthesiologica Scandinavica. 2006 ; Vol. 50, No. 7. pp. 869-874.
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AU - Földesi, C.

AU - Nagy, A.

AU - Sáringer, A.

AU - Kiss, A.

AU - Kiss, G.

AU - Marschalkó, P.

AU - Szabó, M.

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KW - Impedance cardiography

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