Haemodynamic stability during moderate hypotensive anaesthesia for spinal surgery. A comparison between desflurane and isoflurane

Beaussier, Marc; Paugam, Charles; Deriaz, H.; Mestari, M; Chandon, M.; Sautet, Alain; Lienhart, A.

doi:10.1034/j.1399-6576.2000.440921.x

Cited by 24 publications

(9 citation statements)

References 16 publications

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“…Similar to our results, Beausier et al concluded that desflurane was better than isoflurane for establishment of hypotension during spinal surgery. [20] Reason for lesser decrease in blood pressure and QTd increase in desflurane group may be related to its sympathetic activity.…”

Section: Discussionmentioning

confidence: 97%

A comparison of the effects of desflurane, sevoflurane and propofol on QT, QTc, and P dispersion on ECG

et al. 2009

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The aim of this prospective, randomized, and double-blinded study was to compare the effects of desflurane, sevoflurane, propofol on both atrial and ventricular wall function by measurement of QT dispersion (QTd), corrected QT dispersion (QTcd), and P dispersion (Pd) on electrocardiogram (ECG). Forty-six patients from the American Society of Anesthesiologists class I-II undergoing noncardiac surgery, were enrolled in this study. Patients were randomly allocated to receive desflurane, sevoflurane or propofol anesthesia. ECG recordings were taken before and after 5 minutes of drug administration. Induction with desflurane significantly increased the QTd compared to baseline (38 +/- 2 ms vs. 62 +/- 6 ms, P 0.05). Sevoflurane and propofol anesthesia was not associated with any changes in QTd. QTcd was increased with desflurane induction and decreased with sevoflurane and propofol induction, but this decrease was only significant in the propofol group (67 +/- 5 ms vs. 45 +/- 3 ms, P 0.05). Pd was significantly increased after induction with desflurane (34 +/- 3 vs. 63 +/- 6 ms, P 0.05). There was a significant increase in QTd and Pd in desflurane group, but this increment did not cause any dangerous arrhythmias. QTcd significantly decreased in propofol group. We believe that further investigations are required for using desflurane as safe as sevoflurane and propofol in noncardiac surgery patients who have high cardiac arrhythmia and ischemia risk.

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Section: Discussionmentioning

confidence: 97%

A comparison of the effects of desflurane, sevoflurane and propofol on QT, QTc, and P dispersion on ECG

et al. 2009

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“…Systolic BP was 21.2% (9.5–41.7) of time outside the range 80-100 mmHg with isoflurane as compared to 5.1% (0.6–10.3) with desflurane ( P < 0.01). [41]…”

Section: Pharmacokineticsmentioning

confidence: 99%

Desflurane - Revisited

Kapoor

Vakamudi

2012

J Anaesthesiol Clin Pharmacol

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The search for an ideal inhalational general anesthetic agent continues. Desflurane, which was recently introduced in the Indian market, possesses favorable pharmacokinetic and pharmacodynamic properties and is closer to the definition of an ideal agent. It offers the advantage of precise control over depth of anesthesia along with a rapid, predictable, and clear-headed recovery with minimal postoperative sequelae, making it a valuable anesthetic agent for maintenance in adults and pediatric patients in surgeries of all durations. The agent has advantages when used in extremes of age and in the obese. Its use may increase the direct costs of providing anesthetic care. Methods or techniques, such as low-flow anesthesia, to reduce the overall cost and along with minimal environmental implications must be followed.

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“…Desflurane is characterized by rapid elimination and early recovery from anesthesia [3]. Although desflurane elicits sympathetic activation, hypertension, and tachycardia when its inspired concentration exceeds 1.0 minimum alveolar concentration (MAC) [4], it provides faster and tighter hemodynamic control than other volatile agents at lower than 1.0 MAC [5,6], suggesting that desflurane might be safely used during anesthesia for resection of pheochromocytomas. However, there have been only a few reports describing anesthesia with desflurane in patients undergoing pheochromocytoma surgery [7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Use of desflurane during anesthesia for resection of extra-adrenal pheochromocytoma: a case report

Oda¹,

Adachi²,

Komatsu³

et al. 2018

JA Clin Rep

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Background: Although various agents are used during anesthesia for surgical resection of pheochromocytoma, application of desflurane has rarely been reported. We report the use of desflurane in a case receiving resection of extra-adrenal pheochromocytoma. Case presentation: A 51-year-old female was transferred to our hospital for sustained hypertension. A diagnosis of extra-adrenal pheochromocytoma was made based on increased plasma catecholamine levels and radiographic findings. Surgical resection was planned after controlling blood pressure. General anesthesia was induced with propofol and fentanyl, followed by maintenance with desflurane 4.3% and remifentanil 0.2-0.4 μg/kg/min. Blood pressure and heart rate were stable during induction, tracheal intubation, and tumor manipulation. Blood pressure abruptly decreased to 62/40 mmHg after removal of the tumor, which was treated with noradrenaline. The surgery was completed uneventfully and the postoperative course was also uneventful. Conclusion: Desflurane was safely used in combination with remifentanil during anesthesia for resection of extraadrenal pheochromocytoma.

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Haemodynamic stability during moderate hypotensive anaesthesia for spinal surgery. A comparison between desflurane and isoflurane

Abstract: Desflurane, administered via a semi-closed circuit at 1 l x min(-1) fresh gas flow, maintained better haemodynamic stability in spinal surgery requiring moderate arterial hypotension than isoflurane.

Cited by 24 publications

References 16 publications

A comparison of the effects of desflurane, sevoflurane and propofol on QT, QTc, and P dispersion on ECG

A comparison of the effects of desflurane, sevoflurane and propofol on QT, QTc, and P dispersion on ECG

Desflurane - Revisited

Use of desflurane during anesthesia for resection of extra-adrenal pheochromocytoma: a case report

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