Comparison of Arterial Baroreflex Function in Humans Anesthetized with Enflurane or Isoflurane

To compare the depressive effects of isoflurane and enflurane on the arterial baroreflex function, we examined baroreflex control of heart rate during the entire course of clinical anesthesia. Isoflurane and enflurane were found to have similar depressive effects on the baroreflex control of heart rate when used in combination with N2O and O2. Suppression in the baroreflex sensitivity, defined by the slopes of regression line (change in msec of RR interval per mm Hg increase or decrease in systolic blood pressure) was from 7.1 ± 3.9 to 1.8 ± 0.7 msec/mm Hg in patients given isoflurane and from 7.8 ± 4.3 to 3.0 ± 1.9 msec/mm Hg in those given enflurane when evaluated by a pressor test (bolus IV phenylephrine), The slope of the depressor test (bolus IV nitroglycerin) also decreased from 4.7 ± 2.8 to 1.9 ± 1.5 msec/mm Hg with isoflurane and from 5.6 ± 3.2 to 2.3 ± 1.2 msec/mm Hg with enflurane. During surgery in which anesthetic concentration invariably needed to be increased, the suppression of the baroreflex sensitivity remained unchanged in both groups of patients. During recovery, the arterial baroreflex function in patients given isoflurane recovered more rapidly than that in patients given enflurane. This difference may be related to a more minor degree of suppression of isoflurane on the autonomic nervous system compared to enflurane.

[1]  C. Ferrario,et al.  Sodium balance and the reflex regulation of baroreceptor function. , 1987, Circulation.

[2]  C Prys-Roberts,et al.  Restoration of baroreflex control of heart rate during recovery from anaesthesia. , 1986, British journal of anaesthesia.

[3]  K. Samii,et al.  Influence of Venous Return on Baroreflex Control of Heart Rate during Lumbar Epidural Anesthesia in Humans , 1986, Anesthesiology.

[4]  J. Kampine,et al.  Halothane Anesthesia Attenuates Cardiopulmonary Baroreflex Control of Peripheral Resistance in Humans , 1985, Anesthesiology.

[5]  S. Dohi,et al.  Circulatory Responses to Baroreflexes, Valsalva Maneuver, Coughing, Swallowing, and Nasal Stimulation during Acute Cardiac Sympathectomy by Epidural Blockade in Awake Humans , 1985, Anesthesiology.

[6]  Y. Donchin,et al.  Respiratory Sinus Arrhythmia during Recovery from Isoflurane—Nitrous Oxide Anesthesia , 1985, Anesthesia and analgesia.

[7]  T. Ebert,et al.  Baroreceptor Reflex Control of Heart Rate during Morphine Sulfate, Diazepam, N2O/O2 Anesthesia in Humans , 1984, Anesthesiology.

[8]  R. Roy.  Does isoflurane really preserve baroreflex responsiveness better than halothane or enflurane? , 1984, Anesthesiology.

[9]  Z. Bosnjak,et al.  Sympathetic Efferent Nerve Activity in Conscious and Isoflurane‐anesthetized Dogs , 1984, Anesthesiology.

[10]  M. N. Levy,et al.  Cardiac sympathetic-parasympathetic interactions. , 1984, Federation proceedings.

[11]  L. Hegedüs,et al.  Effects of surgical stress and insulin on cardiovascular function and norepinephrine kinetics. , 1984, The American journal of physiology.

[12]  J. Kampine,et al.  Baroreceptor Reflex Control of Heart Rate during Isoflurane Anesthesia in Humans , 1984, Anesthesiology.

[13]  E. Freye,et al.  Naloxone reverses the hypnotic effect and the depressed baroreceptor reflex of halothane anaesthesia in the dog. , 1984, Canadian Anaesthetists' Society journal.

[14]  O. Werner,et al.  Modification by Baroreceptor Feedback of Circulatory Responses to Noxious Stimuli During Anaesthesia in Cats , 1983, Acta anaesthesiologica Scandinavica.

[15]  S. Dohi,et al.  Baroreflex Control of Heart Rate during Cardiac Sympathectomy by Epidural Anesthesia in Lightly Anesthetized Humans , 1983, Anesthesia and analgesia.

[16]  P. Sleight,et al.  Involvement of the baroreceptor reflexes in the changes in blood pressure with sleep and mental arousal. , 1983, Hypertension.

[17]  J. Rowe,et al.  Post-cough heart rate response: influence of age, sex, and basal blood pressure. , 1983, The American journal of physiology.

[18]  I. Kissin,et al.  Heart rate response to nociceptive stimulation as an index of anesthetic potency for enflurane. , 1983, Anesthesiology.

[19]  J. Kalbfleisch,et al.  Halothane and the Carotid Sinus Reflex: Evidence for Multiple Sites of Action , 1982, Anesthesiology.

[20]  S. Chien,et al.  Resetting of Baroreflex Sensitivity after Induced Hypotension , 1982, Anesthesiology.

[21]  B. Rusy,et al.  Effects of Enflurane on Release of Insulin by Pancreatic Islets in Vitro , 1981, Anesthesia and analgesia.

[22]  E. Eger,et al.  Isoflurane: a review. , 1981, Anesthesiology.

[23]  R. Merin,et al.  Are the Myocardial Functional and Metabolic Effects of Isoflurane Really Different from Those of Halothane and Enflurane? , 1981, Anesthesiology.

[24]  M F Roizen,et al.  Anesthetic Doses Blocking Adrenergic (Stress) and Cardiovascular Responses to Incision—MAC BAR , 1981, Anesthesiology.

[25]  P. Duke,et al.  The effect of halothane with nitrous oxide on baroreflex control of heart rate in man , 1980, Canadian Anaesthetists' Society journal.

[26]  D. Eckberg.  Parasympathetic cardiovascular control in human disease: a critical review of methods and results. , 1980, The American journal of physiology.

[27]  S. Glantz,et al.  Heart Rate‐Systemic Blood Pressure Relationship in Dogs During Halothane Anesthesia , 1980, Acta anaesthesiologica Scandinavica.

[28]  P. Duke,et al.  Baroreflex Control of Heart Rate in Man Awake and during Enflurane and Enflurane—Nitrous Oxide Anesthesia , 1980, Anesthesiology.

[29]  A. Brown,et al.  Individual and Combined Actions of Calcium, Sodium, and Potassium Ions on Baroreceptors in the Rat , 1979, Circulation research.

[30]  R. Cox,et al.  Influence of anesthesia on the response to carotid hypotension in dogs. , 1979, The American journal of physiology.

[31]  P. Skovsted,et al.  The effects of isoflurane on arterial pressure, pulse rate, autonomic nervous activity, and barostatic reflexes , 1977, Canadian Anaesthetists' Society journal.

[32]  P. Duke,et al.  Halothane depresses baroreflex control of heart rate in man. , 1977, Anesthesiology.

[33]  R. Bergman,et al.  Direct enhancement of insulin secretion by vagal stimulation of the isolated pancreas. , 1973, The American journal of physiology.

[34]  E. Eger,et al.  Comparative toxicity of isoflurane, halothane, fluroxene and diethyl ether in human volunteers , 1973, Canadian Anaesthetists' Society journal.

[35]  D. Porte,et al.  Neural regulation of insulin secretion in the dog. , 1973, The Journal of clinical investigation.

[36]  H. L. Price,et al.  The Effects of Ēthrane on Arterial Pressure, Preganglionic Sympathetic Activity, and Barostatic Reflexes , 1972, Anesthesiology.

[37]  N. T. Smith,et al.  Clinical Signs of Anesthesia , 1972, Anesthesiology.

[38]  J. Wade,et al.  The effect of methoxyflurane on baroreflex control of heart rate in man , 1972, Canadian Anaesthetists' Society journal.

[39]  R Peto,et al.  Effect of Age and High Blood Pressure on Barorefiex Sensitivity in Man , 1971, Circulation research.

[40]  E B Brown,et al.  The effects of hypercapnia, hypoxia and ventilation on the baroreflex regulation of the pulse interval , 1971, The Journal of physiology.

[41]  H. L. Price,et al.  The Effects of Halothane on Arterial Pressure. Preganglionic Sympathetic Activity and Barostatic Reflexes , 1969, Anesthesiology.

[42]  H. L. Price,et al.  The Effects of Methoxyflurane on Arterial Pressure, Preganglionic Sympathetic Activity and Barostatic Reflexes , 1969, Anesthesiology.

[43]  T. Pickering,et al.  Effects of Anesthesia on Baroreflex Control of Heart Rate in Man , 1969, Anesthesiology.

[44]  P. Bolme,et al.  Effects of anesthetics on circulatory regulatory mechanisms in the dog. , 1966, The Journal of pharmacology and experimental therapeutics.

[45]  L. Share.  Vascular volume and blood level of antidiuretic hormone. , 1962, The American journal of physiology.