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Titolo:
DESFLURANE-MEDIATED SYMPATHETIC ACTIVATION OCCURS IN HUMANS DESPITE PREVENTING HYPOTENSION AND BARORECEPTOR UNLOADING
Autore:
EBERT TJ; PEREZ F; UHRICH TD; DESHUR MA;
Indirizzi:
VET ADM MED CTR,112A,5000 W NATL AVE MILWAUKEE WI 53295 MED COLL WISCONSIN,DEPT ANESTHESIOL MILWAUKEE WI 53226
Titolo Testata:
Anesthesiology
fascicolo: 5, volume: 88, anno: 1998,
pagine: 1227 - 1232
Fonte:
ISI
Lingua:
ENG
Soggetto:
CAROTID-SINUS BARORECEPTORS; CARDIOVASCULAR STIMULATION; BLOOD-PRESSURE; HEART-RATE; ISOFLURANE; ANESTHESIA; RESPONSES; REFLEX; SEVOFLURANE; INCREASES;
Keywords:
AUTONOMIC NERVOUS SYSTEM; BLOOD PRESSURE; HEART RATE; ISOFLURANE; SYMPATHETIC MICRONEUROGRAPHY; SYMPATHETIC PRESSORECEPTORS; VOLATILE ANESTHETICS;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
19
Recensione:
Indirizzi per estratti:
Citazione:
T.J. Ebert et al., "DESFLURANE-MEDIATED SYMPATHETIC ACTIVATION OCCURS IN HUMANS DESPITE PREVENTING HYPOTENSION AND BARORECEPTOR UNLOADING", Anesthesiology, 88(5), 1998, pp. 1227-1232

Abstract

Background: Increasing concentrations of desflurane result in progressive decreases in blood pressure (BP) and, unlike other currently marketed, potent volatile anesthetics, heightened sympathetic nervous system activity. This study aimed to determine whether baroreflex mechanisms are involved in desflurane-mediated sympathetic excitation. Methods: Healthy volunteers were anesthetized with desflurane (n = 8) or isoflurane (n = 9). Heart rate (HR; measured by electrocardiograph), bloodpressure (BP; measured by arterial catheter), and efferent sympathetic nerve activity (SNA; obtained from percutaneous recordings from the peroneal nerve) were monitored. Baroreflex sensitivity was evaluated at baseline while volunteers were conscious and during 0.5, 1, and 1.5 minimum alveolar concentration (MAC) anesthesia via bolus injections of nitroprusside (100 mu g) and phenylephrine (150 mu g) to decrease and increase BP. To prevent the BP decline with increasing depths of anesthesia, phenylephrine mas infused to maintain mean BP at the 0.5 MAC level. Results: The HR, BP, and SNA were similar between the groups atthe conscious baseline measurement, Efferent SNA did not change during higher MAC of isoflurane, but it increased progressively as desflurane concentrations were increased beyond 0.5 MAC, despite maintaining BP at the 0.5 MAC value with phenylephrine infusions (P < 0.05). Cardiac baroslopes (based on changes in HR) were progressively and similarlydecreased with increasing concentrations of isoflurane and desflurane(P < 0.05). Sympathetic baroslopes Chased on SNA) decreased with increasing isoflurane concentrations but mere maintained with increasing concentrations of desflurane; the response was significantly different between groups. Conclusions: The increase in basal levels of SNA with increasing concentrations of desflurane persisted despite ''fixing'' BP and thus is probably not due to hypotension and unloading of the baroreceptors, Further, the preservation of reflex increases in SNA to nitroprusside during desflurane indicates that desflurane preserves one component of the baroreflex in humans when BP is ''fixed.''

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Documento generato il 03/07/20 alle ore 01:08:39