Comparison of the epinephrine-induced arrhythmogenic effect of sevoflurane with isoflurane and halothane

Imamura, Satoshi; Ikeda, Kazuyuki

doi:10.1007/s0054070010062

Cited by 38 publications

(17 citation statements)

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“…15 16 It produces similar degrees of myocardial depression and hypotension to equipotent concentrations of halothane in children 10 and less sensitisation of the myocardium to catecholamines. 17 The degree of respiratory depression is similar to that produced by halothane at equipotent concentrations. 18 19 nificantly reduced or eliminated.…”

Section: Sevofluranementioning

confidence: 77%

Science, medicine, and the future: Role of molecular cell biology in understanding disease

Savill¹

1997

BMJ

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About one quarter of the population are aged under 15 years and many of them will require anaesthesia and surgery. Several recent developments have contributed to making anaesthesia for children easier, safer, and more pleasant for the child and parents. Topical cutaneous anaesthesiaOne of the most unpleasant procedures for children in hospital is insertion of a venous cannula for induction of anaesthesia, taking blood samples, or administering fluid and drugs. To try to reduce the pain associated with the procedure a topically active local anaesthetic preparation is applied such as Emla cream (a mixture of 2.5 mg/ml of lignocaine and 2.5 mg/ml of prilocaine). To work properly Emla cream has to be applied at least an hour before the procedure, 1 2 which means it is not suitable for emergency and some day case patients. Even when applied for 60 minutes it is effective in only 65% of children, 3 although this proportion rises if it is left in place for 90-120 minutes. 4 Emla cream also causes vasoconstriction at the site of application, which can make venepuncture difficult. 5 The recent development and licensing of a topical cream made with the local anaesthetic amethocaine has greatly improved topical anaesthesia. Amethocaine has a much higher lipid solubility than Emla and penetrates the stratum corneum, the main barrier to absorption of drugs through the skin, with comparative ease. A gel containing 4% amethocaine has been shown to provide analgesia for venous cannulation in over 80% of children compared with 66% of children who had Emla cream applied for the same period. 6This makes amethocaine particularly useful in outpatient day case surgery. Amethocaine has also been found to cause erythema and vasodilatation at the site of application, which may facilitate venous cannulation. 7 SevofluraneOne of the ways in which paediatric anaesthesia differs from adult anaesthesia is that inhalational induction is used much more commonly. The characteristics of the volatile anaesthetic agent used are important. It needs to induce anaesthesia quickly, have a low incidence of complications such as coughing, laryngospasm, and hypoxia during induction, and allow rapid recovery. Until recently halothane was the most commonly used agent, and this generally results in smooth, trouble free inductions. However, a new agent, sevoflurane, is now available in Britain which has very low solubility in blood (the blood-gas partition coefficient is 0.47 compared with 2.1 for halothane). Studies have shown that it induces anaesthesia more rapidly than halothane, [8][9][10][11][12] and it is also eliminated more quickly from the blood, producing a faster recovery. [10][11][12][13][14] Sevoflurane has a pleasant smell and is the least irritant of the volatile agents to the respiratory tract. There is a low incidence of respiratory tract irritation during its use.15 16 It produces similar degrees of myocardial depression and hypotension to equipotent concentrations of halothane in children 10 and less sensitisation of the myocardium...

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Section: Sevofluranementioning

confidence: 77%

Science, medicine, and the future: Role of molecular cell biology in understanding disease

Savill¹

1997

BMJ

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“…On the other hand, no patient had arrhythmia in the sevoflurane group. Sevoflurane dose not appear to be arrhythmogenic in dogs, and the arrhythmogenic dose of epinephrine exceeds that found during anesthesia with isoflurane [10]. This is an advantage during anesthesia for cesarean section.…”

Section: Discussionmentioning

confidence: 95%

Comparison of sevoflurane and other volatile anesthetics for cesarean section

et al. 1995

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“…The movements were in the form of moderate extremity movements joined by the wrist joint. Immamura et al [14] reported that in patients having sevoflurane anesthesia, the risk of arrhythmia inducted with the adrenaline discharge under hypoxic and hypercarbic conditions was less than in halothane. Sevoflurane and halothane were reported as the most suitable agents in terms of cardiovascular parameters in anesthesia induction with mask [15].…”

Section: Discussionmentioning

confidence: 99%

Comparison of the depth of anesthesia in sevoflurane and halothane anesthesia with bispectral index and 95% spectral edge frequency

Gökahmetoğlu¹

2013

Diclemedj

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ÖZETAmaç: Bu çalışmanın amacı, bispektral indeks (BIS) ve % 95 spektral edge frekans (SEF) monitorizasyon sistemleri kullanarak, halotan ve sevofluran anestezi derinliklerinin değerlendirilmesidir.Yöntemler: [2001][2002] yılları arasında, yaşları 20 ile 60 arasında değişen, genel anestezi altında jinekolojik operasyon geçiren 40 hasta çalışmaya dahil edildi. Anestezi indüksiyonu Grup I hastalarda (n=20) halotan, Grup II hastalarda sevofluran ile konvansiyonel spontan inhalasyon indüksiyon metodu ile sağlandı. SEF ve BIS indeks değerleri kaydedildi. Bulgular:Her iki grupta entübasyon öncesi ve sonrası, cilt insizyon öncesi ve sonrası SEF değerleri, bazal değerlerine göre anlamlı derecede düşüktü (p<0,05). Aynı zamanda, her iki grupta anestezi indüksiyonu sonrası kaydedilen SEF değerleri anlamlı olarak bazal değerler-den yüksekti (p<0,05). Ekstübasyon sonrası kaydedilen SEF değerleri kıyaslandığında, iki grup arasında istatistiksel olarak anlamlı fark bulundu (p<0.05). Her iki grupta da, anestezi indüksiyonu sonrası, entübasyon öncesi, entübasyon sonrası, cilt insizyon öncesi ve sonrası kaydedilen BIS değerleri, bazal ve ekstübasyon sonrası kaydedilen değerlere kıyasla anlamlı derecede düşüktü (p<0.05). Entübasyon öncesi ve entübasyondan bir dakika sonra kaydedilen BIS değerlerine bakıldığında, her iki grup arasında istatistiksel olarak anlamlı fark bulundu (p<0,05).Sonuç: Sonuç olarak BIS ve SEF değerleri anestezinin hipnotik komponentini değerlendirmede yardımcı olabilir ve bunlar peroperatif sempatik ve cerrahi uyaranlara karşı otonomik cevapların gösterilmesinde yeterli değildir.Anahtar kelimeler: Bispectral indeks, halotan, sevofluran, anestezi derinliği, hemodinamik değişiklikler ABSTRACT Objective: The aim of the present study was to evaluate the depth of anesthesia provided by halothane or sevoflurane by using the bispectral index (BIS) and 95% spectral edge frequency (SEF) monitoring systems. Methods:Forty patients, between the ages of 20-60 years, scheduled for gynecological surgery under general anesthesia were studied between the years 2001-2002. Anesthesia induction was maintained by conventional spontaneous inhalation induction method with sevoflurane in the group I patients (n=20), with halothane in the group II patients (n=20). SEF and BIS index values were recorded. Results:In both groups, SEF values recorded before intubation, after intubation, before and after skin incision were significantly lower compared with values recorded at baseline (p<0.05). Also, SEF values in both groups recorded after anesthesia induction were significantly higher compared with baseline values (p<0.05). Regarding the recorded SEF values after extubation, there were statistically significant differences between the two groups (p<0.05). In both groups, BIS values recorded after anesthesia induction, before intubation, after intubation, before and after skin incision were significantly lower compared with values recorded at baseline and after extubation (p<0.05). Regarding the recorded BIS values before intubation and 1 ...

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Comparison of the epinephrine-induced arrhythmogenic effect of sevoflurane with isoflurane and halothane

Cited by 38 publications

References 15 publications

Science, medicine, and the future: Role of molecular cell biology in understanding disease

Science, medicine, and the future: Role of molecular cell biology in understanding disease

Comparison of sevoflurane and other volatile anesthetics for cesarean section

Comparison of the depth of anesthesia in sevoflurane and halothane anesthesia with bispectral index and 95% spectral edge frequency

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