Abstract:

Objective: To compare the application of sevoflurane inhalation and ketamine combined with propofol intravenous
anesthesia in the transcatheter closure for children with congenital heart diseasen, and to discuss the feasibility and safety of using sevoflurane inhalation. Methods: Sixty children, aged 2 to 5 years old, body weight 8- 14 kg, ASA Ⅰ or Ⅱ, with pediatric
interventional therapy were randomly divided into two groups: sevoflurane inhalation anesthesia group （sevoflurane group） and ketamine combined with propofol intravenous anesthesia group（ketamine group）. Sevoflurane group were anesthesia induction with 8% sevoflurane（oxygen flow rate at 6 L/min）and anesthesia maintenance with 2%-3%sevoflurane（oxygen flow rate 2 L/min）.Ketamine group were anesthesia induction with 1.5~2.0 mg/kg ketamine intravenously and anesthesia maintenance with 25~30 μg/（kg·min）ketamine, 1.5-2.0 mg/（kg·h）propofol trace pump injection continuously. SBP, DBP, HR, SpO2, anesthesia induction time, recovery time,and postoperative complications were recorded and investigated. Results: There were no differences between general information and operation time in two groups. The sedation and analgesia effect were satisfactory in all patients, and no case was changed to tracheal intubation. The induction time in two groups were not significantly different. But the postoperative recovery time,orientation recovery time in sevoflurane group were shorter than that in ketamine group（P< 0.05）. There was no statistic significant difference on consciousness limb activity between sevoflurane group（3 cases, 10%）and ketamine group（5 cases,17%）. The two groups were free of cough, adverse respiratory inhibition, laryngospasm and bronchospasm. The incidence of agitation during emergence in sevoflurane group（10% 3 cases）was significantly lower than that in the ketamine group（17%, 5 cases）（P < 0.05）.
Conclusion: Sevoflurane inhalation anesthesia, with little influence on circulation and respiration, could achieve satisfactory analgesia and sedation, is safe and effective in interventional therapy of children with congenital heart disease.

Key words: sevoflurane, children, congenital heart disease, interventional