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Titolo:
Fenoldopam for controlled hypotension during spinal fusion in children andadolescents
Autore:
Tobias, JD;
Indirizzi:
Univ Missouri, Dept Child Hlth, Hlth Sci Ctr M658, Div Pediat Crit Care Pediat Anesthesiol, Columbia, MO 65212 USA Univ Missouri Columbia MO USA 65212 t Anesthesiol, Columbia, MO 65212 USA Univ Missouri, Dept Anesthesiol, Div Pediat Crit Care Pediat Anesthesiol, Columbia, MO 65212 USA Univ Missouri Columbia MO USA 65212 t Anesthesiol, Columbia, MO 65212 USA
Titolo Testata:
PAEDIATRIC ANAESTHESIA
fascicolo: 3, volume: 10, anno: 2000,
pagine: 261 - 266
SICI:
1155-5645(200005)10:3<261:FFCHDS>2.0.ZU;2-Z
Fonte:
ISI
Lingua:
ENG
Soggetto:
SEVERE SYSTEMIC HYPERTENSION; INTRAVENOUS FENOLDOPAM; SODIUM-NITROPRUSSIDE; BLOOD-PRESSURE; AGONIST; SURGERY; NITROGLYCERIN; NICARDIPINE; MESYLATE;
Keywords:
fenoldopam; controlled hypotension; spinal fusion;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
22
Recensione:
Indirizzi per estratti:
Indirizzo: Tobias, JD Univ Missouri, Dept Child Hlth, Hlth Sci Ctr M658, Div Pediat Crit Care Pediat Anesthesiol, 1 Hosp Dr, Columbia, MO 65212 USA Univ Missouri 1 Hosp Dr Columbia MO USA 65212 bia, MO 65212 USA
Citazione:
J.D. Tobias, "Fenoldopam for controlled hypotension during spinal fusion in children andadolescents", PAEDIATR AN, 10(3), 2000, pp. 261-266

Abstract

Fenoldopam is a dopamine(1) agonist whose pharmacological effects include vasodilation of the vascular beds of the kidney, mesentery, skeletal muscle, and coronary systems, resulting in a decrease in systemic vascular resistance and mean arterial pressure. The current retrospective review outlines the use of fenoldopam for controlled hypotension during anterior or posterior spinal fusion in 10 children and adolescents, aged 8-14 years and weighing 22-61 kg. Fenoldopam was infused at a starting dose of 0.3-0.5 mu g.kg(-1).min(-1) and increased incrementally to achieve a mean arterial pressure (MAP) of 50-65 mmHg. The desired MAP was achieved in 4-11 min (7 +/- 2.5 min). The fenoldopam infusion was administered for 135-225 min (160 +/- 25 min) in doses ranging from 0.2 to 2.5 mu g.kg(-1).min(-1). The mean fenoldopam infusion rate for the 10 cases varied from 0.5 to 1.4 mu g.kg(-1).min(-1)(1.0 +/- 0.3 mu g.kg(-1).min(-1)). No excessive hypotension or clinically significant adverse effects were noted. Statistically significant, but clinically insignificant, increases in heart rate and decreases in PaO2 were noted during the fenoldopam infusion. The baseline heart rate increased from 87 +/- 13 b.min(-1) to a maximum of 114 +/- 16 b.min(-1) (P < 0.0001) during the fenoldopam infusion. In the six patients undergoing posterior spinal fusion, the baseline PaO2 decreased from 232 +/- 7 mmHg to a low of 199 +/-11 mmHg (P=0.0004) during the fenoldopam infusion. Fenoldopam can be used to provide controlled hypotension during spinal surgery in children and adolescents. Future studies, with direct comparison to other commonly used agents, are needed to better define its advantages and disadvantages as well as its effects on estimated blood loss.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 16/07/20 alle ore 06:41:41