Background : In paediatric healthy patients and in real peroperative conditions, the cardiovascular effects of isoflurane have been poorly described. Methods : We have evaluated the myocardial effects of 1% end‐expired concentration (EEC) of isoflurane in 25 healthy infants or small children undergoing superficial surgical therapy for small burns with a continuous aortic blood flow echo‐Doppler device. Aortic blood flow (ABF) was measured with a small oesophageal probe specially designed for infants. The aortic flowmeter was connected with satelitte devices to visualize the haemodynamic profile variations during the isoflurane inhalation period. Results : Isoflurane significantly decreased ABF and increased pre‐ejection period/left ventricular ejection time (PEP/LVET), when compared with control values previously recorded 5 min after induction with halothane‐fentanyl and atracurium (respectively, 80 ± 7%, mean ± SD; P <0.001 and 111 ± 11%; P =0.017, 5 min after EEC of isoflurane reached 1%, then respectively, 75 ± 12%; P <0.001 and 119 ± 16%; P <0.001, at the end of the isoflurane inhalation period). These variations reversed to a great extent when isoflurane was switched off (97 ± 17% for ABF; P =0.08 and 105 ± 12% for PEP/LVET; P =0.75). Among the usual parameters, 1% EEC of isoflurane caused no significant changes in heart rate, moderately decreased mean arterial pressure (successively, 88 ± 12%; P =0.045 and 87 ± 19%; P =0.049), but belatedly decreased end‐tidal CO 2 pressure (87 ± 11% at the end of the inhalation period ( P <0.001) which persisted 5 min after isoflurane was turned off (90 ± 11%; P <0.001)). Conclusions : These findings suggest that isoflurane can transiently depress cardiac function in healthy infants.
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