EFFECTS OF KETAMINE, HALOTHANE, ENFLURANE, AND ISOFLURANE ON SYSTEMIC AND SPLANCHNIC HEMODYNAMICS IN NORMOVOLEMIC AND HYPOVOLEMIC CIRRHOTIC RATS

The effects of ketamine, halothane, enflurane, and isoflurane on systemic and splanchnic hemodynamics in cirrhotic rats that were either normovolemic or hypovolemic following hemorrhage were characterized. Rats received at random either ketamine (30 mg/kg iv, 1.5 mg · kg-1 · min-1 iv), halothane, enflurane, or isoflurane (1 MAC). Conscious rats were considered the control group. Four weeks before hemodynamic studies bile duct ligation was performed in all rats to induce cirrhosis. Hemodynamic measurements were performed using the radioactive microsphere method 1 h after the onset of anesthesia and 30 min after hemorrhage. Anesthetized rat lungs were mechanically ventilated with room air. Before hemorrhage cardiac index was higher in conscious rats and in rats receiving isoflurane than in the other groups (P < 0.001). Hepatic arterial blood flow was similar in conscious rats and in those receiving isoflurane or halothane and was higher than in those receiving ketamine or enflurane. The lowest splanchnic and portal venous tributary blood flows were observed in rats receiving enflurane. After hemorrhage cardiac index was significantly less than before hemorrhage in all groups, except in rats receiving enflurane. After hemorrhage portal venous tributary blood flow decreased significantly in all groups except in enflurane group. During halothane and enflurane anesthesia hepatic arterial blood flow and a hepatic arterial fraction of cardiac output decreased (P < 0.01) and they were maintained in the other groups. After hemorrhage hepatic arterial fraction of cardiac output in conscious rats was higher than in those receiving ketamine, halothane, or enflurane (P < 0.05) and was similar to those receiving isoflurane. Thus, halothane inhibited the increase of hepatic arterial blood flow, whereas it was maintained under isoflurane as in normals. Furthermore, in normovolemic cirrhotic rats hepatic arterial blood flow was preserved only during halothane and isoflurane. After hemorrhage among the agents and doses studied, isoflurane seems the most efficient for preserving splanchnic circulation in hypovolemic cirrhotic rats.