Hemodynamic and catecholamine response to a rapid increase in isoflurane or sevoflurane concentration during a maintenance phase of anesthesia in humans

被引：70

作者：

Nishiyama T. ^{[1
,2
]}

机构：

[1] Department of Anesthesiology, Faculty of Medicine, The University of Tokyo, Bukyo-ku, Tokyo 113-8655

[2] Kawaguchi 332-0015

来源：

Journal of Anesthesia | 2005年 / 19卷 / 3期

关键词：

Anesthetic concentration; Catecholamine; Isoflurane; Sevoflurane;

D O I：

10.1007/s00540-005-0318-0

中图分类号：

学科分类号：

摘要：

Purpose. The purpose of this study was to compare hemodynamic and catecholamine changes due to a sudden increase in inhalation anesthetic concentrations (isoflurane and sevoflurane) during surgery. Methods. Th irty patients aged 40-70 years scheduled for lower abdominal surgery were anesthetized with either isoflurane or sevoflurane with nitrous oxide and epidural block. During surgery the isoflurane or sevoflurane concentration was kept at 0.5 minimum alveolar concentration (MAC) (end-tidal concentration) for 15 min. Then the isoflurane or sevoflurane concentration (inhalation concentration) was changed to 1.5 MAC and maintained at that level for 10 min. Thereafter, it was decreased to 0.5 MAC for 10 min. Blood pressure, heart rate, and plasma concentrations of epinephrine and norepinephrine were measured. Results. The blood pressure decreased significantly in both groups after increasing the anesthetic concentration, and it increased after decreasing the concentration. The decrease in systolic blood pressure was significantly larger in the isoflurane group. The heart rate increased significantly after increasing the anesthetic concentration only in the isoflurane group. Plasma concentrations of epinephrine and norepinephrine increased significantly in the isoflurane group, whereas the epinephrine concentration (but not the norepinephrine concentration) decreased in the sevoflurane group. Conclusion. During surgery a sudden increase in isoflurane concentration induced larger changes in hemodynamics and sympathetic nerve activity than sevoflurane. © JSA 2005.

引用

页码：213 / 217

页数：4

共 20 条

[1]

Tanaka S., Tsuchida H., Namba H., Namiki A., Clonidine and lidocaine inhibition of isoflurane-induced tachycardia in humans, Anesthesiology, 81, pp. 1341-1349, (1994)

[2]

Ishikawa T., Nishino T., Hiraga K., Immediate responses of arterial blood pressure and heart rate to sudden inhalation of high concentrations of isoflurane in normotensive and hypertensive patients, Anesth. Analg., 77, pp. 1022-1025, (1993)

[3]

Tanaka S., Tsuchida H., Nakabayashi K., Seki S., Namiki A., The effects of sevoflurane, isoflurane, halothane, and enflurane on hemodynamic responses during an inhaled induction of anesthesia via a mask in humans, Anesth. Analg., 82, pp. 821-826, (1996)

[4]

Wajima Z., Inoue T., Yoshikawa T., Imanaga K., Ogawa R., Changes in hemodynamic variables and catecholamine levels after rapid increase in sevoflurane or isoflurane concentration with or without nitrous oxide under endotracheal intubation, J. Anesth., 14, pp. 175-179, (2000)

[5]

Dolan W.M., Stevens W.C., Eger E.I., Cromwell T.H., Halsey M.J., Shakespeare T.F., Miller R.D., The cardiovascular and respiratory effects of isoflurane-nitrous oxide anesthesia, Can. Anaesth. Soc. J., 21, pp. 557-568, (1974)

[6]

Stevens W.C., Cromwell T.H., Halsey M.J., Eger II E.I., Shakespeare T.F., Bahlman S.H., The cardiovascular effects of a new inhalation anesthetic, Forane, in human volunteers at constant arterial carbon dioxide tension, Anesthesiology, 35, pp. 8-16, (1971)

[7]

Skovsted P., Sapthavichaikul S., The effects of isoflurane on arterial pressure, pulse rate, automonic nervous activity, and barostatic reflexes, Can. Anaesth. Soc. J., 24, pp. 304-314, (1977)

[8]

Seagard J.L., Hopp F.A., Bosnjak Z.J., Osborn J.L., Kampine J.P., Sympathetic efferent nerve activity in conscious and isoflurane anesthetized dogs, Anesthesiology, 61, pp. 266-270, (1984)

[9]

Weiskopf R.B., Moore M.A., Eger II E.I., Noorani M., McKay L., Chortkoff B., Hart P.S., Damask M., Rapid increase in desflurane concentration is associated with greater transient cardiovascular stimulation than with rapid increase in isoflurane concentration in humans, Anesthesiology, 80, pp. 1035-1045, (1994)

[10]

Yli-Hankala A., Randell T., Seppala T., Lindgren L., Increases in hemodynamic variables and catecholamine levels after rapid increase in isoflurane concentration, Anesthesiology, 78, pp. 266-271, (1993)

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