A 5 year old Child is suffering from patent ductus aeriosus (PDA) with congestive cardiac failure.Ligatio of ductus aeriosus was decided for surgical management.The most apropriate inhalation anaesthetic agent of the choice with minimal haemodynamic alteration for induction of anaethesia is
Sevoflurane is the inducing agent of choice in children . Cardiovascular stability in decreasing order : Isoflurane(nost stable)>desflurane>Sevoflurane>Halothane>Enflurane. Halothane suppresses baroreceptor reflex and causes tachycardia (Arrythmogenic -by sensitising the hea to catecholamines) Enflurane is most cardiovascular unstable agent Isoflurane is the most cardiostable inhalational agent as cardiac output is best maintained by reflex tachycardia as protective baroreceptor reflex is minimally inhibited. Among Isoflurane and sevoflurane, sevoflurane is the agent of choice in children. Ref.:Morgan 4th/e p 929
Sevoflurane
Isoflurane
Enflurane
Halothen
Anaesthesia of special situations