An assessment of desflurane for use during cardiac electrophysiological study and radiofrequency ablation of supraventricular dysrhythmias in children

Desflurane has several properties making it a desirable agent for use in el ectrophysiological studies (EPS) for diagnosis and treatment of cardiac dys rhythmias. We studied 47 children, mean age 12.8 +/- 4.6 years, mean weight 52.9 +/- 24.0 kg, with clinical history of supra- ventricular tachycardia (SVT) during EPS using desflurane in a crossover comparison with fentanyl. The patients served as their own controls. All received oral premedication with lorazepam, and intravenous induction with thiopentone, rocuronium, and oxygen. Group 1 (n=24) were administered fentanyl 10 mu g.kg(-1) bolus i.v . with an infusion of 3 mu g.kg(-1).h(-1) during initial EPS. Fentanyl was discontinued and desflurane, 6% endtidal, was administered and the EPS repe ated. Group 2 (n=23) were initially administered 6% desflurane after induct ion, and following EPS the desflurane was discontinued and the patients adm inistered fentanyl 3 mu g.kg(-1) bolus and EPS repeated (explanations of EP S abbreviations are provided). Desflurane reduced the mean arterial pressur e (MAP) in all patients. In Group 1, desflurane shortened the sinus cycle l ength (SCL), i.e. increasing the heart rate, and atrial effective refractor y period (AERP) while Group 2 demonstrated no such effect on AERP. There we re no other significant differences between fentanyl or desflurane techniqu es in terms of EPS measurements. SVT was inducible with both agents in both groups. Desflurane seems an acceptable agent for use during EPS procedures .