[Effects of premedication in children with congenital cardiopathy].

OBJECTIVES

To evaluate the effects of premedication in children with congenital heart disease.

MATERIAL AND METHODS

Twenty-five children scheduled for surgical repair of congenital heart defects were studied. Two groups were formed based on whether cardiopathy was noncyanotic (group CNC) or cyanotic (group CC). Patients were premedicated rectally with 4 mg/kg pentobarbital and, 15 minutes later, with 0.15 mg/kg of morphine chloride by subcutaneous perfusion. SpO2 was monitored, as was the degree of sedation and airway obstruction prior to premedication (T1), 15 minutes after administration of pentobarbital (T2) and 30 minutes after morphine (T3).

RESULTS

In the children with cyanotic cardiopathy, SpO2 increased over T1 (75.5 +/- 8.7%) at times T2 (76.2 +/- 7.7%) and T3 (78.1 +/- 8%), although the change was not statistically significant. In group CNC, average SpO2 did not change, although one case of clinically significant desaturation due to hypoventilation was observed at T3. Adequate sedation was attained in 36% of patients at T2 and in 80% at T3 (p < 0.002). There were no cases of airway obstruction.

CONCLUSION

Premedication with 4 mg/kg pentobarbital rectally does not provide adequate sedation. Addition of 0.15 mg/kg subcutaneous morphine chloride increased the effect considerably, providing stability in SpO2 and even improving it in group CC.