Influence of intravenous anesthetics on pulmonary vascular resistance in patients with congenital heart disease complicated by pulmonary hypertension / 中华麻醉学杂志

ABSTRACT

Objective To determine if thiopental, propofol and ketamine can be safely used for induction of anesthesia in patients with congenital heart disease complicated by pulmonary hypertension. Methods Eighteen patients with congenital heart disease complicated by pulmonary hypertension were studied. Age ranged from 14 to 31 yr and body weight from 35 to 57 kg. The patients were premedicated with intramuscular pethidine 1 mg? kg-1 and scopolamine 0.3 mg. Swan-Ganz catheter was inserted through internal jugular vein. The patients were randomized to receive thiopental 2 mg?kg-1 , propofol 1 mg?kg-1 or ketamine 1 mg?kg-1 administered slowly via Swan-Ganz catheter for induction of anesthesia. MAP, high arterial pressure (RPA), mean pulmonary arterial pressure (MPAP), pulmonary arterial wedge pressure (PAWP), cardiac output (CO) and pulmonary vascular resistance (PVR) were measured before induction of the intravenous anesthetics. Results PVR unchanged significantly after ketamine , thiopental and propofol as compared with the baseline value. MAP was significantly decreased after injection of thiopental and propofol. Conclusion Thiopental, propofol and ketamine can be safely used for induction of anesthesia in patients with congenital heart disease complicated by pulmonary hypertension.