Inhalative Anästhetika

Deile, M.; Damm, Martin; Heller, Axel R.

doi:10.1007/s00101-013-2175-9

Cited by 16 publications

(11 citation statements)

References 20 publications

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“…Xenon was described in this context to show a vagotonic effect [46]. In contrast, the heart rates under isoflurane anaesthesia are mainly reported as remaining unchanged [26, 27, 29, 46], whereas our analysis showed also a heart rate decrease. The reason for this observation remains unclear.…”

Section: Discussioncontrasting

confidence: 45%

Better haemodynamic stability under xenon anaesthesia than under isoflurane anaesthesia during partial nephrectomy – a secondary analysis of a randomised controlled trial

et al. 2019

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Background Renal dysfunction following intraoperative arterial hypotension is mainly caused by an insufficient renal blood flow. It is associated with higher mortality and morbidity rates. We hypothesised that the intraoperative haemodynamics are more stable during xenon anaesthesia than during isoflurane anaesthesia in patients undergoing partial nephrectomy. Methods We performed a secondary analysis of the haemodynamic variables collected during the randomised, single-blinded, single-centre PaNeX study, which analysed the postoperative renal function in 46 patients who underwent partial nephrectomy. The patients received either xenon or isoflurane anaesthesia with 1:1 allocation ratio. We analysed the duration of the intraoperative systolic blood pressure decrease by > 40% from baseline values and the cumulative duration of a mean arterial blood pressure (MAP) of < 65 mmHg as primary outcomes. The secondary outcomes were related to other blood pressure thresholds, the amount of administered norepinephrine, and the analysis of confounding factors on the haemodynamic stability. Results The periods of an MAP of < 65 mmHg were significantly shorter in the xenon group than in the isoflurane group. The medians [interquartile range] were 0 [0–10.0] and 25.0 [10.0–47.5] minutes, for the xenon and isoflurane group, respectively ( P = 0.002). However, the cumulative duration of a systolic blood pressure decrease by > 40% did not significantly differ between the groups ( P = 0.51). The periods with a systolic blood pressure decrease by 20% from baseline, MAP decrease to values < 60 mmHg, and the need for norepinephrine, as well as the cumulative dose of norepinephrine were significantly shorter and lower, respectively, in the xenon group. The confounding factors, such as demographic data, surgical technique, or anaesthesia data, were similar in the two groups. Conclusion The patients undergoing xenon anaesthesia showed a better haemodynamic stability, which might be attributed to the xenon properties. The indirect effect of xenon anaesthesia might be of importance for the preservation of renal function during renal surgery and needs further elaboration. Trial registration ClinicalTrials.gov : NCT01839084. Registered 24 April 2013. Electronic supplementary material The online version of this article (10.1186/s12871-019-0799-2) contains supplementary material, which is available to authorized users.

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Section: Discussioncontrasting

confidence: 45%

Better haemodynamic stability under xenon anaesthesia than under isoflurane anaesthesia during partial nephrectomy – a secondary analysis of a randomised controlled trial

et al. 2019

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“…Currently, inhaled anesthetics are standard care in general anesthesia 7 . Despite many common properties, each inhaled anesthetic has its own characteristics: desflurane seems to maintain cardiopulmonary function at best, sevoflurane outperforms in terms of adverse effects like airway irritation, and isoflurane shows a high blood-gas partition coefficient, thus minimalized consumption and faster induction and awakening time 4 , 8 .…”

Section: Discussionmentioning

confidence: 99%

“…While desflurane and sevoflurane show the strongest negative inotropic effects, desflurane and isoflurane can cause an increase in heart rate. With regard to the respiratory system, all three anesthetics cause a bronchodilation, while desflurane and isoflurane can trigger laryngeal spasms and are therefore considered unfeasible for induction of anesthesia 8 .…”

Section: Introductionmentioning

confidence: 99%

The effect of desflurane, isoflurane and sevoflurane on the hemoglobin oxygen dissociation curve in human blood samples

Ronzani

Woyke

Mair

et al. 2022

Sci Rep

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Desflurane, isoflurane and sevoflurane, three halogenated ethers, are commonly used inhaled anesthetics, both in the operating room and in the intensive care unit (ICU). The potency and dosage of these drugs is expressed by the MAC value (minimum alveolar concentration). Their interaction with hemoglobin and its affinity for oxygen, best described by the oxygen dissociation curve (ODC), has already been investigated, with conflicting results. Altered by many factors, the ODC can be shifted to the left or to the right, therefore increasing or decreasing hemoglobin oxygen (Hb-O2) affinity. In venous blood samples of 22 healthy participants (11 female, 11 male) ODC were measured with a high-throughput method in vitro. Blood samples were either exposed to control or to three different concentrations of desflurane, isoflurane or sevoflurane prior to and during measurements (low, medium and high corresponding to MAC 0.5, MAC 1.0 and MAC 2.0). With increasing concentrations from control to medium, desflurane and isoflurane significantly decreased Hb-O2 affinity by shifting the ODC to the right (p = 0.016 and p < 0.001) but sevoflurane showed no effects. When further increasing concentrations from medium to high, all three inhaled anesthetics shifted the ODC back to the left (p < 0.001). Comparing only controls to high concentrations, a significant increase in Hb-O2 affinity for desflurane (p = 0.005) and sevoflurane (p < 0.001) was detected. Our study shows a varying effect at different doses of inhaled anesthetics on Hb-O2 affinity. While the underlying mechanisms remain unclear, these results show an effect which needs to be further investigated to determine if patients undergoing anesthesia may potentially benefit or get disadvantage from this slightly increased (e.g. impaired pulmonary oxygen uptake), or decreased Hb-O2 affinity (e.g. arterial vascular disease).Trial registration: This study is registered with clinicaltrials.gov (NCT04612270).

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“…In contrast to our hypothesis, no group differences on the cardiac and aortic parameters could be identified using echocardiography. Anesthesia is known to relax vascular tone and baroreceptor reflexes, resulting in hypotension 32,33 which may potentially affect the measurements. However, isoflurane anesthesia is generally known to have minimal cardiodepressant effects in comparison to other anesthetic agents, 34,35 and as anesthetizing the mice for the echocardiography procedures was necessary, a minor relaxation of vascular tone was accepted and was assumed to be equal across groups.…”

Section: Discussionmentioning

confidence: 99%

Ultrasonographic and histological evaluation of the effects of long-term carotid catheterization on cardiac function in NMRI mice

et al. 2017

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Catheterization of laboratory mice is commonly performed in biomedical research to infuse substances and for blood sampling. One approach is to catheterize the right common carotid artery and advance the catheter until the tip is positioned in the aorta or the proximal brachiocephalic trunk. Owing to the small body size of the mouse, a catheter tends to occupy a great part of even the larger vessel lumens, and this may increase vascular resistance with potential pathophysiological impacts on the heart. The present study compared cardiac function of catheterized mice, with catheter tip placement in the brachiocephalic trunk, with sham-operated mice and non-operated control mice. During four weeks post-catheterization, M-mode echocardiography measurements of the thickness of the left ventricular anterior wall, left ventricular inner diameter and the thickness of the left ventricular posterior wall were performed. The left ventricular volume, ejection fraction and fractional shortening were calculated. Moreover, aortic recordings of the thickness of the medial and lateral walls as well as the inner diameter were measured. Terminally, histological analysis of the hearts was conducted, and body weights and heart weights were compared between groups. No effects on echocardiography parameters, histology, body weights or cardiac weights could be found between groups. In the present study, implantation of a carotid catheter with catheter tip placement in the proximal brachiocephalic trunk had minimal influence on cardiac and aortic physiology and did not induce significant cardiac changes.

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Inhalative Anästhetika

Cited by 16 publications

References 20 publications

Better haemodynamic stability under xenon anaesthesia than under isoflurane anaesthesia during partial nephrectomy – a secondary analysis of a randomised controlled trial

Better haemodynamic stability under xenon anaesthesia than under isoflurane anaesthesia during partial nephrectomy – a secondary analysis of a randomised controlled trial

The effect of desflurane, isoflurane and sevoflurane on the hemoglobin oxygen dissociation curve in human blood samples

Ultrasonographic and histological evaluation of the effects of long-term carotid catheterization on cardiac function in NMRI mice

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