Influence of premedication on the sympathetic and endocrine responses and cardiac arrhythmias during halothane anaesthesia in children undergoing adenoidectomy

• Published in: British journal of anaesthesia : BJA 1983-10, Vol.55 (10), p.961-968
• Main Authors: Sigurdsson, G H, Lindahl, S, Nordén, N
• Format: Article
• Language: English
• Subjects: Adenoidectomy; Anesthesia, Inhalation; Arrhythmias, Cardiac - prevention & control; Atropine - therapeutic use; Child; Child, Preschool; Diazepam - therapeutic use; Drug Therapy, Combination; Halothane; Humans; Infant; Intraoperative Complications - prevention & control; Morphine - therapeutic use; Preanesthetic Medication; Pulmonary Gas Exchange - drug effects; Scopolamine - therapeutic use
• ISSN: 0007-0912
• DOI: 10.1093/bja/55.10.961

The occurrence of cardiac arrhythmia was investigated in 80 children during halothane anaesthesia for adenoidectomy. Two different premedications were studied. Forty children (group A) were premedicated with diazepam 5 mg rectally and atropine 0.3-0.4 mg sublingually and 40 (group B) received a rectal solution including diazepam 0.5 mg kg-1, morphine 0.15 mg kg-1 and hyoscine 0.01 mg kg-1. In 17 of these children (nine in group A and eight in group B) plasma concentrations of catecholamines, ACTH and corticosteroids were measured. In group A the mean plasma concentration of catecholamines increased more than 300% during surgery, while it was virtually unchanged in group B (P less than 0.01). Plasma concentrations of ACTH, cortisol and 17-alpha-hydroxyprogesterone were also greater in group A than in group B. The occurrence of ventricular arrhythmias in group A was significantly more frequent (20.0%) than in group B (2.5%) (P less than 0.05). It was concluded that in these two comparable groups of patients ventricular arrhythmia during halothane anaesthesia was almost eliminated by the use of more effective premedication, as a result of decreases in the sympathetic and endocrine responses to surgery.