SOME PULMONARY AND CARDIOVASCULAR EFFECTS OF ENFLURANE (ETHRANE) ANAESTHESIA WITH VARYING PaCO2 IN MAN

Marshall, Bryan E.; Cohen, Peter J.; Klingenmaier, C. H.; Neigh, John L.; PENDER, JOHN W.

doi:10.1097/00132586-197210000-00046

Cited by 8 publications

(11 citation statements)

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“…The use of atropine and gallamine may well explain the difference in findings. We have no explanation for the difference in findings between our study and that of MARSHALL et al (1971), where unpremedicated patients did not react to enflurane with an increase in pulse rate. It is possible, however, that control measurements in the study of MARSHALL et al (1971) were performed on anxious or nervous patients.…”

Section: Discussioncontrasting

confidence: 97%

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Heart Rate Changes Caused by Enflurane and Halothane Anaesthesia in Man

Heiberg

Wiberg-Josrgensen

Skovsted

1979

Survey of Anesthesiology

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Changes in heart rate and arterial pressure caused by enflurane and halothane anaesthesia were investigated in patients premedicated with diazepam and scopolamine. Enflurane caused a significant (12%) increase in heart rate and depression of arterial pressure (23%). Halothane depressed heart rate significantly (14%), whereas arterial pressure was unaffected. The authors conclude that enflurane possesses a positive chronotropic effect.Studies in man have shown that halothane does not affect heart rate, although an initial short-lasting depression may occur ( EGER et al. 1970, PRICE et al. 1970, EGER et al. 1971.Studies on the effect of enflurane on heart rate in man show divergent results. MARSHALL et al. (1971) found enflurane not to affect pulse rate in man, whereas LEVESQUE et al. (1974) found enflurane to cause a significant increase in pulse rate in man.This study was cai-ried out to investigate whether enflurane does, in fact, possess a positive chronotropic action in man. MATERIAL AND METHODSTwenty patients (13 women and 7 men), all physical status I and scheduled for elective surgical procedures, were studied. The patients were informed about the nature of the investigation and their consent was obtained. Ten patients (median age 39 y, range 23-65 y) received enflurane anaesthesia, and 10 patients (median age 15 y, range 25-64 y) received halothane anaesthesia. Allocation into the two groups was random.The patients were premedicated using diazepam 0.15 mg per kg body weight and scopolamine 0.3 mg, given intramuscularly 14 h before anaesthesia. Anaesthesia was induced by mask with N20-02enflurane or N20-02-halothane, respectively; a semi-closed circle system with absorber was used with spontaneous respiration and gas-flow rates of 6-8 1 per min.Enflurane was administered using a calibrated Enflurotecm vaporizer, with an initial concentration of 4-5%, and for halothane a calibrated Fluotecm vaporizer, with an initial concentration of 2-3%, was used.After light levels of anaesthesia had been reached, nitrous oxide was discontinued and the vaporizers were set at a concentration of enflurane 2.5% or halothane 1 .O%, respectively (equipotent concentrations of approximately 1.5 MAC). Anaesthesia was maintained at these concentrations of enflurane and halothane in oxygen, and measurements were performed 5 min after nitrous oxide had been discontinued. Prior to and during anaesthesia, the ECG was continuously recorded and the median value of the heart rate was measured.Blood pressure was measured indirectly by the Riva-Rocci technique. Mean arterial blood pressure was calculated as the diastolic pressure plus one third of the pulse pressure.Blood samples were drawn from a radial or brachial arteryprior to anaesthesia and after 5 minof halothane/ enflurane-02 anaesthesia. They were analyzed by a Radiometer" ABL2 for Pao, and Pacol.Statistical analyses were performed within groups by Wilcoxon's test for paired differences, whereas comparison of the two groups was made using the Mann-Whitney test. Differences were ...

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Section: Discussioncontrasting

confidence: 97%

“…Studies on the effect of enflurane on heart rate in man show divergent results. MARSHALL et al (1971) found enflurane not to affect pulse rate in man, whereas LEVESQUE et al (1974) found enflurane to cause a significant increase in pulse rate in man.…”

mentioning

confidence: 98%

Heart Rate Changes Caused by Enflurane and Halothane Anaesthesia in Man

Heiberg

Wiberg-Josrgensen

Skovsted

1979

Survey of Anesthesiology

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“…Second hypercarbia itself may have directly stimulated the sympathetic nervous system, resulting in increased cardiac output and MAP [18,21]. Then hypercarbia also may have stimulated sympathetic nervous system indirectly by increasing plasma catecholamine concentration, including epinephrine and norepinephrine [21].…”

Section: Discussionmentioning

confidence: 99%

Effects of pneumoperitoneum on cardiac autonomic nervous activity evaluated by heart rate variability analysis during sevoflurane, isoflurane, or propofol anesthesia

et al. 2000

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“…Most studies showed, however, that enflurane lowered T P R in man (KARLICZEK et al 1974, LEVESQUE et al 1974, CALVERLEY et al 1975, SANTESSON et al 1978, in the monkey ( RITZMAN et al 1976), and in the dog (BEER et al 1973, PETER et al 1974, TARNOW et al 1974, which is in agreement with the findings in the present study. The reasons why the effects on T P R vary qualitatively between the cited studies may be found in differences in the experimental approach or variations in Pco2 (MARSHALL et al 1971). The fall in TPR observed in our experiments may have been caused by several factors, such as depression of central sympathetic activity and sympathetic ganglionic transmission or transmission between post-ganglionic fibres and smooth muscle fibres, direct smooth muscle depression or autoregulation in different vascular beds.…”

Section: Blood Pressuresmentioning

confidence: 99%

“…The cardiovascular effects of enflurane have been extensively studied both in man and in experimental animals. Most studies in man have shown little impairment of cardiovascular function (DOBKIN et al 1968, HELRICH & CASCORBI 1969, SHIMOSATO & ETSTEN 1969, MARSHALL et al 1971, GRAVES & DOWNS 1974, LEVESQUE et al 1974, HALDEMANN et al 1975, while other studies have demonstrated a moderate (KARLICZEK et al , JORFELDT 1977 or marked (CALVERLEY et al 1975) cardiovascular depression. Surgical stimulation, however, reversed enflurane-induced circulatory de-pression (SANTESSON et al 1978).…”

mentioning

confidence: 99%

Effects of Enflurane on Haemodynamics and Oxygen Consumption in the Dog with Special Reference‐ to the Liver and Preportal Tissues

Irestedt

Andreen

1979

Acta Anaesthesiol Scand

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The effects of enflurane anaesthesia on central circulation, total oxygen uptake, splanchnic circulation and splanchnic oxygen uptake were studied in 10 artifically ventilated dogs, basally anaesthetized with thiopental and nitrous oxide. Hepatic arterial, superior mesenteric arterial and portal venous blood flows were measured with electromagnetic flowmetry. Cardiac output was measured by thermodilution. Determinations of oxygen contents were made in arterial, pulmonary arterial, portal venous and hepatic venous blood. The end-tidal enflurane concentration was kept at about 1 MAC (= 2.2%). Arterial blood pressure diminished 54% of control value due to decreases of cardiac output to 65% and of total peripheral vascular resistance to 81% of control values. Hepatic arterial, superior mesenteric arterial and portal venous blood flows decreased to 65-70% of control levels and the corresponding vascular resistances all declined to about 80-85% of control values. Total oxygen uptake decreased, but less than cardiac output, leading to an increased arterio-venous oxygen content difference. Oxygen uptake of the preportal tissues was unchanged and hepatic oxygen uptake was not significantly altered, although there were decreases in hepatic oxygen uptake in some of the individual experiments. It is suggested that the cardiovascular depression following enflurane anaesthesia in the dog was due, to a great extent, to a primary myocardial depression. It is further concluded that the splanchnic blood flows were relatively well preserved, due to decreases in splanchnic vascular resistances, and that hepatic and preportal tissue oxygen consumptions were maintained by increased oxygen extraction.

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SOME PULMONARY AND CARDIOVASCULAR EFFECTS OF ENFLURANE (ETHRANE) ANAESTHESIA WITH VARYING PaCO2 IN MAN

Cited by 8 publications

References 0 publications

Heart Rate Changes Caused by Enflurane and Halothane Anaesthesia in Man

Heart Rate Changes Caused by Enflurane and Halothane Anaesthesia in Man

Effects of pneumoperitoneum on cardiac autonomic nervous activity evaluated by heart rate variability analysis during sevoflurane, isoflurane, or propofol anesthesia

Effects of Enflurane on Haemodynamics and Oxygen Consumption in the Dog with Special Reference‐ to the Liver and Preportal Tissues

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