Department of Anesthesiology, University of Michigan Health Systems, F3900 Mott Hospital, Ann Arbor, MI 48109-5211, USA.
J Clin Anesth. 2010 Dec;22(8):592-7. doi: 10.1016/j.jclinane.2010.05.002.
To evaluate whether children with Down Syndrome are at increased risk of bradycardia and hypotension during and following sevoflurane induction.
Retrospective study.
University-affiliated children's hospital.
The records of children with Down syndrome and a sample matched by age, congenital heart defect, and ASA physical status, were searched. Demographics, history of Down syndrome or congenital heart anomaly, heart rate (HR), mean arterial pressure (MAP), and end-tidal concentration of sevoflurane (EtSevo) at baseline and following induction were recorded.
96 children with Down syndrome were identified from 11,201 pediatric anesthetics (< 1%). Demographics were similar in the matched sample. The Down syndrome group was more likely to experience bradycardia and had greater decreases in HR from baseline. These findings were similar for children with or without congenital heart defects. There were no differences between groups in the number who were treated with a pharmacologic agent.
A significantly higher prevalence and degree of bradycardia occurred in children with Down syndrome during and following sevoflurane induction, which was corrected by decreasing the concentration of sevoflurane and airway manipulation.
评估唐氏综合征儿童在七氟醚诱导期间和之后是否有心动过缓和低血压的风险。
回顾性研究。
大学附属儿童医院。
搜索了唐氏综合征儿童和按年龄、先天性心脏缺陷和 ASA 身体状况匹配的样本的记录。记录了人口统计学资料、唐氏综合征或先天性心脏异常的病史、心率（HR）、平均动脉压（MAP）和七氟醚呼气末浓度（EtSevo）在基线和诱导后的情况。
从 11201 例儿科麻醉中确定了 96 例唐氏综合征儿童（<1%）。匹配样本中的人口统计学资料相似。唐氏综合征组更易发生心动过缓，且 HR 从基线下降幅度更大。这些发现对于有或没有先天性心脏缺陷的儿童都是相似的。两组在需要使用药物治疗的人数方面没有差异。
唐氏综合征儿童在七氟醚诱导期间和之后，心动过缓的发生率和严重程度显著升高，通过降低七氟醚浓度和气道操作可以纠正。
