Hormonal Blood Pressure Regulation during General Anesthesia Using a Standardized Propofol Dosage in Children and Adolescents Seems Not to Be Affected by Body Weight
Obesity in pediatric surgical patients is a challenge for the anesthesiologist. Despite potentially beneficial properties, propofol might also induce hypotension. This study examined whether a dose adjustment in overweight children could avoid hypotension and if there would be differences regarding...
Main Authors: | , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
MDPI AG
2020-07-01
|
Series: | Journal of Clinical Medicine |
Subjects: | |
Online Access: | https://www.mdpi.com/2077-0383/9/7/2129 |
id |
doaj-c34d24c8d62b4ce5a19acc88cb63cd85 |
---|---|
record_format |
Article |
spelling |
doaj-c34d24c8d62b4ce5a19acc88cb63cd852020-11-25T02:59:36ZengMDPI AGJournal of Clinical Medicine2077-03832020-07-0192129212910.3390/jcm9072129Hormonal Blood Pressure Regulation during General Anesthesia Using a Standardized Propofol Dosage in Children and Adolescents Seems Not to Be Affected by Body WeightGunther Hempel0Anne-Marie Maier1Tobias Piegeler2Sebastian N. Stehr3Jürgen Kratzsch4Claudia Höhne5Department of Anesthesiology and Intensive Care, University of Leipzig Medical Center, 04103 Leipzig, GermanyDepartment of Anesthesiology and Intensive Care, University of Leipzig Medical Center, 04103 Leipzig, GermanyDepartment of Anesthesiology and Intensive Care, University of Leipzig Medical Center, 04103 Leipzig, GermanyDepartment of Anesthesiology and Intensive Care, University of Leipzig Medical Center, 04103 Leipzig, GermanyInstitute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University of Leipzig Medical Center, 04103 Leipzig, GermanyDepartment of Anesthesiology, Intensive Care Medicine and Pain Therapy, DRK Hospital Berlin-Koepenick, 12559 Berlin, GermanyObesity in pediatric surgical patients is a challenge for the anesthesiologist. Despite potentially beneficial properties, propofol might also induce hypotension. This study examined whether a dose adjustment in overweight children could avoid hypotension and if there would be differences regarding hormonal regulation in children under anesthesia. Fifty-nine children undergoing surgery under general anesthesia were enrolled in this prospective observational trial. Participants were allocated into two groups according to their BMI. The induction of anesthesia was conducted using propofol (“overweight”: 2 mg/kgBW, “regular”: 3.2 mg/kgBW). The maintenance of anesthesia was conducted as total intravenous anesthesia. Hormone levels of renin, angiotensin II, aldosterone, copeptin, norepinephrine and epinephrine were assessed at different timepoints. Blood pressure dropped after the administration of propofol in both groups, with a nadir 2 min after administration—but without a significant difference in the strength of reduction between the two groups. As a reaction, an increase in the plasma levels of renin, angiotensin and aldosterone was observed, while levels of epinephrine, norepinephrine and copeptin dropped. By adjusting the propofol dosage in overweight children, the rate of preincision hypotension could be reduced to the level of normal-weight patients with a non-modified propofol dose. The hormonal counter regulation was comparable in both groups. The release of catecholamines and copeptin as an indicator of arginine vasopressin seemed to be inhibited by propofol.https://www.mdpi.com/2077-0383/9/7/2129pediatric anesthesiaobesityhypotensionRAAS |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Gunther Hempel Anne-Marie Maier Tobias Piegeler Sebastian N. Stehr Jürgen Kratzsch Claudia Höhne |
spellingShingle |
Gunther Hempel Anne-Marie Maier Tobias Piegeler Sebastian N. Stehr Jürgen Kratzsch Claudia Höhne Hormonal Blood Pressure Regulation during General Anesthesia Using a Standardized Propofol Dosage in Children and Adolescents Seems Not to Be Affected by Body Weight Journal of Clinical Medicine pediatric anesthesia obesity hypotension RAAS |
author_facet |
Gunther Hempel Anne-Marie Maier Tobias Piegeler Sebastian N. Stehr Jürgen Kratzsch Claudia Höhne |
author_sort |
Gunther Hempel |
title |
Hormonal Blood Pressure Regulation
during General Anesthesia Using
a Standardized Propofol Dosage
in Children and Adolescents Seems
Not to Be Affected by Body Weight |
title_short |
Hormonal Blood Pressure Regulation
during General Anesthesia Using
a Standardized Propofol Dosage
in Children and Adolescents Seems
Not to Be Affected by Body Weight |
title_full |
Hormonal Blood Pressure Regulation
during General Anesthesia Using
a Standardized Propofol Dosage
in Children and Adolescents Seems
Not to Be Affected by Body Weight |
title_fullStr |
Hormonal Blood Pressure Regulation
during General Anesthesia Using
a Standardized Propofol Dosage
in Children and Adolescents Seems
Not to Be Affected by Body Weight |
title_full_unstemmed |
Hormonal Blood Pressure Regulation
during General Anesthesia Using
a Standardized Propofol Dosage
in Children and Adolescents Seems
Not to Be Affected by Body Weight |
title_sort |
hormonal blood pressure regulation
during general anesthesia using
a standardized propofol dosage
in children and adolescents seems
not to be affected by body weight |
publisher |
MDPI AG |
series |
Journal of Clinical Medicine |
issn |
2077-0383 |
publishDate |
2020-07-01 |
description |
Obesity in pediatric surgical patients is a challenge for the anesthesiologist. Despite potentially beneficial properties, propofol might also induce hypotension. This study examined whether a dose adjustment in overweight children could avoid hypotension and if there would be differences regarding hormonal regulation in children under anesthesia. Fifty-nine children undergoing surgery under general anesthesia were enrolled in this prospective observational trial. Participants were allocated into two groups according to their BMI. The induction of anesthesia was conducted using propofol (“overweight”: 2 mg/kgBW, “regular”: 3.2 mg/kgBW). The maintenance of anesthesia was conducted as total intravenous anesthesia. Hormone levels of renin, angiotensin II, aldosterone, copeptin, norepinephrine and epinephrine were assessed at different timepoints. Blood pressure dropped after the administration of propofol in both groups, with a nadir 2 min after administration—but without a significant difference in the strength of reduction between the two groups. As a reaction, an increase in the plasma levels of renin, angiotensin and aldosterone was observed, while levels of epinephrine, norepinephrine and copeptin dropped. By adjusting the propofol dosage in overweight children, the rate of preincision hypotension could be reduced to the level of normal-weight patients with a non-modified propofol dose. The hormonal counter regulation was comparable in both groups. The release of catecholamines and copeptin as an indicator of arginine vasopressin seemed to be inhibited by propofol. |
topic |
pediatric anesthesia obesity hypotension RAAS |
url |
https://www.mdpi.com/2077-0383/9/7/2129 |
work_keys_str_mv |
AT guntherhempel hormonalbloodpressureregulationduringgeneralanesthesiausingastandardizedpropofoldosageinchildrenandadolescentsseemsnottobeaffectedbybodyweight AT annemariemaier hormonalbloodpressureregulationduringgeneralanesthesiausingastandardizedpropofoldosageinchildrenandadolescentsseemsnottobeaffectedbybodyweight AT tobiaspiegeler hormonalbloodpressureregulationduringgeneralanesthesiausingastandardizedpropofoldosageinchildrenandadolescentsseemsnottobeaffectedbybodyweight AT sebastiannstehr hormonalbloodpressureregulationduringgeneralanesthesiausingastandardizedpropofoldosageinchildrenandadolescentsseemsnottobeaffectedbybodyweight AT jurgenkratzsch hormonalbloodpressureregulationduringgeneralanesthesiausingastandardizedpropofoldosageinchildrenandadolescentsseemsnottobeaffectedbybodyweight AT claudiahohne hormonalbloodpressureregulationduringgeneralanesthesiausingastandardizedpropofoldosageinchildrenandadolescentsseemsnottobeaffectedbybodyweight |
_version_ |
1724701423825846272 |