Clinical Characteristics and Biotransformation of Sevoflurane in Healthy Human Volunteers

Holaday, Duncan A.; Smith, Frederick R.

doi:10.1097/00000542-198102000-00002

Cited by 243 publications

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“…10,11 There are several reports suggesting that volatile anesthetics alter vascular endothelial function or the effect of endotheliumreleased vasodilating factors on vascular smooth muscle activity. In this regard, it has been demonstrated that isoflurane relaxed the vessels without endothelium more than the vessels with endothelium, suggesting that this volatile anesthetic may reduce the release of endothelium-derived relaxing factors or increase the release of endothelium-derived contracting factors.…”

Section: Méthode : Les Expériences Ont éTé Réalisées Sur Des Segmentsmentioning

confidence: 99%

Sevoflurane reduces endothelium-dependent vasorelaxation: role of Superoxide anion and endothelin

et al. 2002

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Section: Méthode : Les Expériences Ont éTé Réalisées Sur Des Segmentsmentioning

confidence: 99%

Sevoflurane reduces endothelium-dependent vasorelaxation: role of Superoxide anion and endothelin

et al. 2002

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“…Sevoflurane (Sev), a new kind of volatile anaesthetic, provides several advantages over other recently available potent inhaled anaesthetics such as halothane and isoflurane (Wallin et al, 1975;Holaday & Smith, 1981;Scheller et al, 1990;Frink et al, 1992). Sev has a higher aqueous solubility than isoflurane or halothane, for more rapid uptake elimination and adjustment of depth, as well as more rapid recovery from anaesthesia (Yasuda et al, 1991;Binstock et al, 1994).…”

Section: Introductionmentioning

confidence: 99%

Potentiation by sevoflurane of the γ‐aminobutyric acid‐induced chloride current in acutely dissociated CA1 pyramidal neurones from rat hippocampus

Harata

Akaike

1996

British J Pharmacology

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1 The effects of a new kind of volatile anaesthetic, sevoflurane (Sev), on y-aminobutyric acid (GABA)-gated chloride current (IcI) in single neurones dissociated from the rat hippocampal CAI area were examined using the nystatin perforated patch recording configuration under the voltage-clamp condition. All drugs were applied with a rapid perfusion system, termed the 'Y-tube' method. 2 When the concentrations were higher than 3 x lo-M, Sev, itself, induced an inward current (Is,V) at a holding potential (VH) of -40 mV. The concentration-response curve of Isev was bell-shaped, with a suppressed peak and plateau currents at high concentrations (above 2 x l0' M). The reversal potential of I&.v (E&,) was close to the theoretical Cl-equilibrium potential, indicating that Isev was carried mainly by Cl-.3 Is,V was reversibly blocked by bicuculline (Bic), an antagonist of the GABAA receptor, in a concentration-dependent manner with a half-inhibitory concentration (IC50) of 7.2 x 10-7 M. But ISev was insensitive to strychnine (Str), an antagonist of the glycine receptor.4 At low concentrations (between 3 x 10-4 and lo-3 M), Sev markedly enhanced the 10-6 M GABA induced current (IGABA) but reduced the IGABA with accelerating desensitization accompanied by a 'hump' current after washout at high concentrations (higher than 2 x 10' M).5 Sev, 10-3 M potentiated the current induced by low concentrations of GABA (between 10-7 and 3 x 10' M) but reduced the current induced by high concentrations (higher than lo-M) of GABA with a clear acceleration of IGABA desensitization.6 Sev, like pentobarbitone (PB), pregnanolone (PGN) or diazepam (DZP), potentiated the 10-6 M GABA-induced response without shifting the reversal potential of IGABA-7 Ise, was augmented by PB, PGN, or DZP at concentrations that maximally potentiated IGABA, suggesting that Sev enhanced IGABA at a binding site distinct from that for PB, PGN, or DZP. 8 It is concluded that Sev acts on the GABAA receptor complex mimicking the GABA-induced chloride current at high concentrations. At low concentrations, Sev enhances GABA-gated chloride current at a binding site independent of the allosteric modulator sites of barbiturates, benzodiazepines or neurosteroids. The reversible potentiation of the inhibitory GABAA receptor-mediated Cl-current may result in the depressing of postsynaptic excitability and may, at least in part, underlie the anaesthetic action of Sev.

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“…However, Ellerkmann et al 16 , evaluating the encephalographic effects of sevoflurane by comparing two methods, BIS and entropy, concluded that both are useful to detect a variation in the depth of hypnosis in function of the concentration of sevoflurane. A reduction in blood pressure, related to the dose of the drug used, is a common effect of potent volatile anesthetics 17 . The primary mechanism by which sevoflurane reduces the arterial blood pressure with increased dosage is related to its potent effect in systemic and regional vascular resistance.…”

Section: Resultsmentioning

confidence: 99%

“…Entretanto, Ellerkmann e col. 16 , avaliando os efeitos encefalográficos do sevoflurano por meio da comparação de dois métodos, BIS e entropia, concluíram que ambos são úteis na detecção da variação da profundidade da hipnose em função da concentração de sevoflurano. O efeito comum dos anestésicos voláteis potentes é a diminuição da pressão arterial relacionada à dose 17 . O mecanismo primário pelo qual o sevoflurano atua na redução da pressão arterial com o aumento da dose está relacionado ao seu potente efeito na resistência vascular sistêmica e regional.…”

Section: Métodounclassified

Avaliação dos efeitos cognitivos da indução inalatória com sevoflurano com ou sem associação com óxido nitroso: estudo comparativo em adultos voluntários

Fernandes

Gomes²,

Cordeiro

et al. 2007

Rev. Bras. Anestesiol.

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RESUMOFernandes CR, Gomes JMA, Cordeiro RAA, Pereira KS -Avaliação dos Efeitos Cognitivos da Indução Inalatória com Sevoflurano com ou sem Associação com Óxido Nitroso. Estudo Comparativo em Adultos Voluntários. JUSTIFICATIVA E OBJETIVOS:A indução com agentes inalatórios via máscara facial vem sendo alvo de crescente interesse desde a introdução do sevoflurano. Ao mesmo tempo a influência da adição de óxido nitroso merece atenção no que diz respeito ao padrão da indução e da recuperação, sobretudo, à completa recuperação da função cognitiva. O objetivo deste estudo foi avaliar os efeitos cognitivos da indução anestésica inalatória com sevoflurano de modo isolado ou associado ao óxido nitroso em adultos. MÉTODO:Foram estudados 20 voluntários adultos, estado físico ASA I, sem doença psiquiátrica ou utilização prévia de benzodiazepínicos. Após terem sido submetidos ao questionário Mini Exame do Estado Mental (MEEM), o Grupo I recebeu sevoflurano na concentração de 5% até que fosse atingido o índice bispectral (BIS) de 60. O Grupo II recebeu óxido nitroso em concentrações crescentes com incremento de 10 até 50% quando então foi administrado o sevoflurano até que fosse atingido o BIS de 60. Foram anotados valores de pressão arterial, freqüência cardíaca, oximetria de pulso, SEF 95% (Spectral Edge Frequency), tempo de indução e o tempo de recuperação anestésica. RESULTADOS:Não houve diferença entre o tempo de indução nos dois grupos. O Grupo II apresentou maior estabilidade hemodinâmica e menor valor do SEF 95% no momento BIS = 60. O tempo para recuperação da função cognitiva foi igual nos dois grupos, assim como a incidência de náuseas e vômitos. Não foi verificada ocorrência de apnéia. O Grupo II apresentou maior incidência de agitação psicomotora durante a indução. CONCLUSÕES:O sevoflurano isoladamente ou em associação com óxido nitroso constituiu opção adequada para indução inalatória ou sedação ambulatorial em adultos, com manutenção da ventilação espontânea, proporcionando rápida recuperação da função cognitiva.Unitermos: ANESTESIA, Geral: inalatória; ANESTÉSICOS, Gasoso, Volátil: óxido nitroso, sevoflurano; SEDAÇÃO: inalatória; SISTEMA NERVOSO CENTRAL: cognição. SUMMARY BACKGROUND AND OBJECTIVES:Anesthetic induction with inhalational agents using a facemask has gained attention since the introduction of sevoflurane. At the same time, the influence of adding nitrous oxide on the pattern of induction and recuperation deserves attention, especially regarding recovery of the cognitive function. The objective of this study was to evaluate the cognitive effects of inhalational anesthetic induction with sevoflurane alone or associated with nitrous oxide in adults. METHODS:Twenty adult volunteers, ASA physical state I, without a history of psychiatric disorders or prior use of benzodiazepines, were enrolled in the study. After answering the Mini-Mental State Examination (MMSE), Group I received 5% sevoflurane until a bispectral index (BIS) of 60 was achieved. Group II received nitrous oxide in increments of 10% until ...

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Clinical Characteristics and Biotransformation of Sevoflurane in Healthy Human Volunteers

Cited by 243 publications

References 0 publications

Sevoflurane reduces endothelium-dependent vasorelaxation: role of Superoxide anion and endothelin

Sevoflurane reduces endothelium-dependent vasorelaxation: role of Superoxide anion and endothelin

Potentiation by sevoflurane of the γ‐aminobutyric acid‐induced chloride current in acutely dissociated CA1 pyramidal neurones from rat hippocampus

Avaliação dos efeitos cognitivos da indução inalatória com sevoflurano com ou sem associação com óxido nitroso: estudo comparativo em adultos voluntários

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