Hemodynamic Changes During Thiopental Anesthesia in Humans: Cardiac Output, Stroke Volume, Total Peripheral Resistance, and Intrathoracic Blood Volume 12

Etsten, Benjamin E.; Li, T. H.

doi:10.1172/jci103099

Cited by 106 publications

(28 citation statements)

References 22 publications

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“…4 The area under the curve was integrated simultaneously by online analog computer (Sanborn 130). Methods of calculating stroke volume index, total peripheral resistance and left ventricular work per rain.…”

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confidence: 99%

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Circulatory effects of enflurane in normocarbic human volunteers

Levesque

Nanagas

Shanks

et al. 1974

Canad. Anaesth. Soc. J.

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RECENT STUDIES have revealed that enflurane (Ethrane| or 1,12-trifluoro-2-ehlorethyl difluoromethyl ether is a potent anaesthetic in both animals and man. 1,~,3 Dobkin and his associates have reported that circulatory dynamics and cardiac rhythm remain relatively stable during enflurane anaesthesia in man, 1 but their findings are complicated by preanaesthetic medication, induction agents, muscle relaxants, surgical trauma, controlled respiration, and respiratory alkalosis. Accordingly, the present study was designed to obtain information on the haemodynamic effects of enflurane in man at constant carbon dioxide tension. METHODSTen male volunteers ranging in age from 21 to 35 years were interviewed and informed consent obtained. The procedures were approved by the Committee on Human Experimentation, Clinical Study Unit, Tufts University School of Medicine and New England Medical Center Hospitals. Each volunteer was admitted to the Clinical Study Unit three days prior to the study for complete history, physical examination, and laboratory tests, including electrocardiogram, chest X-ray, haematocrit, haemoglobin, creatinine, blood urea nitrogen, bilirubin, SGOT, SGPT and LDH, prothrombin time, alkaline phosphatase, sedimentation rate, and urine analysis. To prevent control of ventilation by positive pressure being a factor during the study, the volunteers were trained to use the ventilator. On the day following admission, they were instructed in the use of the Bennett anaesthesia ventilator. Tidal volume and frequency of respiration were set according to the Radford nomogram and the frequency was adjusted to achieve normal ad:erial pH and PaCO_,. The values obtained were noted.On the morning of the experiment, after fasting for at least nine hours, the trained volunteer was brought to the study room. The radial artery was cannulated. A venous catheter (#18 Sorensen) was inserted into the right ventricle through the right basilic vein for measurement of right ventricular end-diastolic pressure. Four surface EKC electrodes were applied. Needle electrodes were placed to obtain bipolar EEG tracings.

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confidence: 99%

“…have been described elsewhere. 4 Ventilation was then controlled by mask using the Bennett Anaesthesia Ventilator set at tidal volume and frequency obtained the preceding day.…”

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confidence: 99%

Circulatory effects of enflurane in normocarbic human volunteers

Levesque

Nanagas

Shanks

et al. 1974

Canad. Anaesth. Soc. J.

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“…As this effect was potentiated by cocaine and abolished by an aadrenoceptor antagonist or by reserpine-treatment (Burn & Hobbs, 1959), it has been suggested that thiopentone produces noradrenaline release. Since thiopentone does not elevate efferent sympathetic activity , it is likely that the increased peripheral resistance, which has been shown to result from administration of thiopentone (Etsten & Li, 1955;Fieldman, Ridley & Wood, 1955), arises from a peripheral effect. The present study confirms that thiopentone, at anaesthetic doses, can produce potentiation of sympathetic vasopressor responses which is of a purely peripheral origin.…”

Section: Discussionmentioning

confidence: 99%

“…The inner cannula was introduced until its tip lay in the left ventricle as measured by the change in the pressure pulse, and the outer one left with its tip in the carotid artery approximately 10 mm from the aorta. A thermistor probe was introduced into the right carotid artery until its tip lay in midstream in the aorta and a cannula was introduced into the right jugular vein for administration of drugs and of cold saline (0.9% w/v NaCl solution) for measurement of cardiac output by the cold dilution method (Fegler, 1954). The rabbit was then turned over into the prone position, its head held rigid in a metal head holder and a 13 mm trephine hole drilled in the parietal area of its skull.…”

Section: Methodsmentioning

confidence: 99%

The Effects of Intravenous Anaesthetics on the Cardiovascular System of the Rabbit

McGrath

Mackenzie

1977

British J Pharmacology

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1 A pithed rabbit preparation is described that allows selective stimulation of the vertebral outflows. 2 The responses to stimulation of sympathetic vasopressor fibres were blocked by hexamethonium and phentolamine but potentiated by cocaine, whereas the responses to stimulation of cardioaccelerator fibres were blocked by propranolol. 3 Ketamine, althesin and pentobarbitone enhanced the effects of noradrenaline and attenuated the effects of sympathetic nerve stimulation. Thiopentone enhanced the effects of both noradrenaline and sympathetic nerve stimulation. 4 In pithed rabbits a transient, dose-related cardiovascular depression was produced by each agent irrespective of whether vasomotor tone was present whereas in decerebrate rabbits the corresponding cardiovascular depression was longer lasting. SIt is concluded that the cardiovascular depression produced by intravenous anaesthetics in intact rabbits is due to a combination of central and peripheral effects.

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“…Several studies allow reasonable quantitative analysis of the himodynamic effects of barbiturates in patients with normal blood pressure (McClure et al, 1939;Johnson, 1951;Winchell, Taylor, and Chapman, 1951;Price et al, 1952;Etsten and Li, 1955). These showed that mean arterial pressure remained unchanged during hypnosis, usually decreased in surgical aneasthesia (4 to 13%), and that the fall was due mostly to a change in systolic pressure.…”

Section: Discussionmentioning

confidence: 99%

THE HAeMODYNAMIC EFFECTS OF SODIUM AMOBARBITAL IN HYPERTENSION

Tuckman¹,

Shillingford²

1964

Heart

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It has long been accepted that barbiturates tend to lower the systemic arterial pressure in patients with hypertension, and this effect has been used in various diagnostic sedation tests. However, because ofthe inadequate description of the drugs' effect on the cardiac output in hypertension, the hmemodynamic mechanism responsible for the hypotensive action is not clear. As barbiturates are often administered at the same time as powerful hypotensive agents either for sedation or anmsthesia, it is important to know the mode of action of the drug on the cardiovascular system.The purpose of this paper is to describe the acute effects of sodium amobarbital on the cardiac output, stroke output, blood pressure, and peripheral resistance in a series of patients with hypertension. SUBJECTS AND METHODSThe subjects of this study were 13 patients with hypertension admitted to the medical wards for diagnosis and treatment: 7 were women and 6 were men, and their average age was 52 years, varying between 29 and 71 years. The diagnoses at the time of discharge are listed in the Table. The average of the control mean arterial pressures was 157 mm. Hg; one of the patients (M. M.) had a normal blood pressure (145/90 mm. Hg) at the time of study although she had had hypertension at the time of admission. None of the patients was acutely ill, had fundoscopic evidence of malignant hypertension (Keith-Wagner grades III and IV), or had signs of peripheral or pulmonary cedema. With the exception of patient M. M., all had electrocardiographic and radiological evidence of minimal to moderate left ventricular hypertrophy. None, except patient E. M., had received drugs during the several weeks before study; E. M. was on daily maintenance digitalis and received three daily oral doses of 60 mg. of guanethidine and one 500 mg. dose of chlorothiazide during the three days preceding investigation.Patients received no premedication and the investigations were begun two hours after a light lunch. Cardiac outputs were measured by the indicator dilution method from dye curves recorded with a photoelectric earpiecet, chopper amplifiert, and direct writer: recording system (Gabe, Tuckman, and Shillingford, 1962). A catheter was passed to the right atrium and then the earpiece fastened to an ear pinna previously treated with vasodilating ointment §. When the catheter and earpiece were in place the patient was allowed to rest quietly for about 30 minutes, after which at least three control measurements of cardiac outputs and right atrial pressures were made; measurements of arterial pressures (by auscultation) and heart rates were obtained more frequently. Sodium amobarbital, 2-5 per cent, was then given slowly into an antecubital vein. The total dosages varied between patients and were decided from observations of arterial pressure

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Hemodynamic Changes During Thiopental Anesthesia in Humans: Cardiac Output, Stroke Volume, Total Peripheral Resistance, and Intrathoracic Blood Volume 12

Cited by 106 publications

References 22 publications

Circulatory effects of enflurane in normocarbic human volunteers

Circulatory effects of enflurane in normocarbic human volunteers

The Effects of Intravenous Anaesthetics on the Cardiovascular System of the Rabbit

THE HAeMODYNAMIC EFFECTS OF SODIUM AMOBARBITAL IN HYPERTENSION

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