Anesthetic Doses Blocking Adrenergic (Stress) and Cardiovascular Responses to Incision—MAC BAR

Roizen, Michael F.; Horrigan, Richard W.; Frazer, Bryan M.

doi:10.1097/00000542-198105000-00008

Cited by 305 publications

(113 citation statements)

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“…11 In the present study, while patients were anesthetized at 1.6 MAC, surgical incision increased arterial blood pressure and HR and the observed increase in Vmca may be due, in part, to increased arterial blood pressure. von Knobelsdorff et al investigated the effects of surgical stimulation on blood flow velocity using TCD in isoflurane anesthetized patients.…”

Section: Discussionmentioning

confidence: 44%

Les changements de vitesse du flux sanguin cérébral, déclenchés par la stimulation chirurgicale, dépendent du niveau de PaCO2

Kawata

Matsumoto

Haranishi

et al. 2001

Can J Anesth/J Can Anesth

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Section: Discussionmentioning

confidence: 44%

Les changements de vitesse du flux sanguin cérébral, déclenchés par la stimulation chirurgicale, dépendent du niveau de PaCO2

Kawata

Matsumoto

Haranishi

et al. 2001

Can J Anesth/J Can Anesth

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“…3 The lower anaesthetic levels obtained in clonidine-treated patients might have led to a slight underestimation of the endocrine and haemodynamic suppressant effects of clonidine, as adrenergic suppressant effects of inhalational anaesthetics have been reported to be dose-dependent. 27 However, in a more recent clinical study, different levels of isoflurane/N20 anaesthesia of 1.3 or 1.8 MAC did not affect heart rate, blood pressure, and plasma cortisol and catecholamine concentrations to different degrees. 28 We believe that in the present study, isoflurane did not contribute to differences in haemodynamic and endocrine responses, observed between the two groups.…”

Section: Discussionmentioning

confidence: 87%

Cardiovascular and endocrine effects of clonidine premedication in neurosurgical patients

et al. 1991

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“…4,5 Attenuation of these responses by spinal or epidural anesthesia 2 suggests involvement of afferent input from the urinary bladder in the cardiovascular reflexes. In the absence of block of the afferent pathway, inadequate anesthesia may produce an unstable cardiovascular status when stimuli are applied 2,6 In addition to the cardiovascular reflexes, both spontaneous contraction and passive distension of the bladder may produce inhibition of respiratory motor neurone activity in anesthetized or decerebrate cats. [7][8][9][10] These findings may indicate that changes in bladder volume could produce abnormal breathing during light general anesthesia.…”

Section: Discussionmentioning

confidence: 99%

“…Roizen et al showed that about 1.5 times MAC was necessary to prevent cardiovascular responses to skin incision. 6 The subjects were allowed to breathe spontaneously in the supine position. The urinary bladder was emptied as much as possible by gentle compression of the lower abdomen.…”

Section: Experimental Protocolmentioning

confidence: 99%

Acute changes in bladder volume produce minimal cardio-respiratory responses in lightly anesthetised humans

Ishikawa

Sato

Nishino

2000

Can J Anesth/J Can Anesth

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Purpose: To examine whether changes in bladder volume elicit reflex cardiovascular and respiratory responses in humans under general anesthesia with sevoflurane and nitrous oxide.Methods: Fourteen patients free of autonomic disorders were anesthetized with sevoflurane 0.5% and nitrous oxide 60% in oxygen that were approximately equivalent to 0.9 MAC. Warmed saline (6 ml·kg -1 , 37°C) was instilled into the pre-emptied urinary bladder, and then the bladder was kept distended for five minutes. Following the distension, the instilled saline was drained to the pre-instilled volume of the bladder. Arterial blood pressure, respiratory flow, and intra-vesicle pressure were continuously measured, and mean arterial pressure, pulse rate, respiratory rate, tidal volume, and minute ventilation were estimated offline from these signals.Results: Bladder emptying produced small decreases in mean blood pressure (from 83.4 ± 4.3 to 80.0 ± 4.4 mmHg, mean ± SE, P =0.017) and pulse rate (from 72.2 ± 2.9 to 69.4 ± 2.7 bpm, mean ± SEM, P =0.004). Only minimal respiratory reflexes were invoked by the bladder volume changes. Conclusion:In lightly anesthetized humans, the acute changes in bladder volume produce only mild cardiovascular and respiratory responses.Objectif : Vérifier si des changements volumiques de la vessie entraînent des réactions cardiovasculaires et respiratoires réflexes chez les humains sous anesthésie générale avec du sévoflurane et du protoxyde d'azote.Méthode : Quatorze patients, sans trouble neurovégétatif, ont été anesthésiés avec du sévoflurane à 0,5 % et un mélange de protoxyde d'azote (60 %) et d'oxygène équivalant à environ 0,9 CAM. Une solution salée réchauf-fée (6 ml·kg -1 , 37 °C) a été introduite dans la vessie, préalablement vidée, qu'on a gardée distendue pendant cinq minutes. On a ensuite drainé la solution pour retrouver le volume vésical initial. La tension artérielle, le débit respiratoire et la pression intravésicale ont été mesurés continûment et la tension artérielle moyenne, la fréquence du pouls, le débit respiratoire, le volume courant et la ventilation minute ont été estimés en différé à partir de ces données.Résultats : La vidange de la vessie a produit de faibles baisses de la pression sanguine moyenne (de 83,4 ± 4,3 à 80,0 ± 4,4 mmHg, moyenne ± erreur type, P = 0,017) et de la fréquence du pouls (de 72,2 ± 2,9 à 69,4 ± 2,7 bpm, moyenne ± erreur type de la moyenne, P = 0,004). Seuls des réflexes respiratoires minimaux ont été provoqués par les changements de volume de la vessie. Conclusion :Chez les humains légèrement anesthésiés, les changements de volume soudains de la vessie ne produisent que de faibles réactions cardiovasculaires et respiratoires.

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Anesthetic Doses Blocking Adrenergic (Stress) and Cardiovascular Responses to Incision—MAC BAR

Cited by 305 publications

References 0 publications

Les changements de vitesse du flux sanguin cérébral, déclenchés par la stimulation chirurgicale, dépendent du niveau de PaCO2

Les changements de vitesse du flux sanguin cérébral, déclenchés par la stimulation chirurgicale, dépendent du niveau de PaCO2

Cardiovascular and endocrine effects of clonidine premedication in neurosurgical patients

Acute changes in bladder volume produce minimal cardio-respiratory responses in lightly anesthetised humans

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