Effects of anaesthesia techniques and drugs on pulmonary function

Saraswat, V

doi:10.4103/0019-5049.165850

Cited by 67 publications

(65 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Ewes cannot be expected to remain still throughout an MRI session, and thus anesthesia is required to protect their well‐being and enable collection of data. However, anesthetic agents can induce cardiovascular depression that may confound measures obtained by MRI (Khan, Hayes, & Buggy, , ; Saraswat, ). Therefore, prior to the conduct of preclinical studies using these technologies, an assessment of the maternal and fetal cardiovascular response to a variety of anesthetic agents is required to provide evidence for selection of the optimum anesthetic protocol.…”

Section: Introductionmentioning

confidence: 99%

Fetal cardiovascular response to acute hypoxia during maternal anesthesia

et al. 2020

View full text Add to dashboard Cite

Preclinical imaging studies of fetal hemodynamics require anesthesia to immobilize the animal. This may induce cardiovascular depression and confound measures under investigation. We compared the impact of four anesthetic regimes upon maternal and fetal blood gas and hemodynamics during baseline periods of normoxia, and in response to an acute hypoxic challenge in pregnant sheep. Merino ewes were surgically prepared with maternal and fetal vascular catheters and a fetal femoral artery flow probe at 105–109 days gestation. At 110–120 days gestation, ewes were anesthetized with either isoflurane (1.6%), isoflurane (0.8%) plus ketamine (3.6 mg·kg−1·h−1), ketamine (12.6 mg·kg−1·h−1) plus midazolam (0.78 mg·kg−1·h−1), propofol (30 mg·kg−1·h−1), or remained conscious. Following 60 min of baseline recording, nitrogen was administered directly into the maternal trachea to displace oxygen and induce maternal and thus fetal hypoxemia. During normoxia, maternal PaO2 was ~30 mmHg lower in anesthetized ewes compared to conscious controls, regardless of the type of anesthesia (p < .001). There was no effect of anesthesia on fetal mean arterial blood pressure (MAP; p > .05), but heart rate was 32 ± 8 bpm lower in fetuses from ewes administered isoflurane (p = .044). During maternal hypoxia, fetal MAP increased, and peripheral blood flow decreased in all fetuses except those administered propofol (p < .05). Unexpectedly, hypoxemia also induced fetal tachycardia regardless of the anesthetic regime (p < .05). These results indicate that despite maternal anesthesia, the fetus can mount a cardiovascular response to acute hypoxia by increasing blood pressure and reducing peripheral blood flow, although the heart rate response may differ from when no anesthesia is present.

show abstract

Section: Introductionmentioning

confidence: 99%

Fetal cardiovascular response to acute hypoxia during maternal anesthesia

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Depending on the level of spinal segment deafferentation, NA is associated with a cardio-depressant effect due to arterial and venous dilatation, with relative hypovolemia. If increased sympathetic activity above the block is an important homeostatic mechanism to maintain blood pressure, COPD patients with right and/or left ventricular dysfunction may tolerate NA and any associated therapeutic measure such as fluid administration very poorly [33,34]. The adverse effects of NA on respiratory function may be listed as follows:…”

Section: Non-invasive Ventilation To Support Lung Function During Neumentioning

confidence: 99%

Non-invasive ventilation during surgery under neuraxial anaesthesia: a pathophysiological perspective on application and benefits and a systematic literature review

Corcione

Karim

Mina

et al. 2019

ait

View full text Add to dashboard Cite

Unlike general anaesthesia, neuraxial anaesthesia (NA) reduces the burden and risk of respiratory adverse events in the post-operative period. However, both patients affected by chronic obstructive pulmonary disease (COPD) and chest wall disorders and/or neuromuscular diseases may experience the development or the worsening of respiratory failure, even during surgery performed under NA; this latter negatively affects the function of accessory respiratory muscles, resulting in a blunted central response to hypercapnia and possibly in an exacerbation of cardiac dysfunction (NA-induced relative hypovolemia). According to European Respiratory Society (ERS) and American Thoracic Society (ATS) guidelines, non-invasive ventilation (NIV) is effective in the post-operative period for the treatment of both impaired pulmonary gas exchange and ventilation, while the intra-operative use of NIV in association with NA is just anecdotally reported in the literature. Whilst NIV does not assure a protected patent airway and requires the patient's cooperation, it is a handy tool during surgery under NA: NIV is reported to be successful for treatment of acute respiratory failure; it may be delivered through the patient's home ventilator, may reverse hypoventilation induced by sedatives or inadvertent spread of anaesthetic up to cervical dermatomes, and allow the avoidance of intubation in patients affected by chronic respiratory failure, prolonging the time of non-invasiveness of respiratory support (i.e., neuromuscular patients needing surgery). All these advantages could make NIV preferable to oxygen in carefully selected patients.

show abstract

“…The induction of general anesthesia leads to changes in the respiratory system including the reduction of tidal volume (TV), forced expiratory volume in the first second (FEV1), and functional residual capacity (FRC) (1)(2)(3). Moreover, decreases in respiratory parameters have been shown after awakening from general anesthesia, especially in patients undergone intra-abdominal surgery (4).…”

Section: Introductionmentioning

confidence: 99%

Effect of Intravenous Propofol and Inhaled Sevoflurane Anesthesia on Postoperative Spirometric Indices: A Randomized Controlled Trial

et al. 2019

View full text Add to dashboard Cite

Background: Anesthetic drugs may directly or indirectly affect respiratory function. We investigated the effects of intravenous propofol and inhaled sevoflurane anesthesia on postoperative spirometric indices in patients undergoing inguinal herniorrhaphy surgery. Methods: We randomly assigned 111 patients, aged 18-65 years, undergoing inguinal herniorrhaphy surgery, to receive either intravenous propofol or inhaled sevoflurane. Forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), and FEV1/FVC were measured before and after anesthesia. Comparisons between the two groups were made using the t-test and ANOVA. Results: There were no significant differences between the two groups in terms of age, sex, height, body weight, BMI, pain score, ASA class, operation duration, and received analgesics. The FEV1 and FVC values significantly decreased after the operation in the sevoflurane group. Conclusions: Both intravenous propofol and inhaled sevoflurane can decrease postoperative spirometry parameters. However, it seems that patients receiving propofol have less decreased spirometric indices.

show abstract

Effects of anaesthesia techniques and drugs on pulmonary function

Cited by 67 publications

References 36 publications

Fetal cardiovascular response to acute hypoxia during maternal anesthesia

Fetal cardiovascular response to acute hypoxia during maternal anesthesia

Non-invasive ventilation during surgery under neuraxial anaesthesia: a pathophysiological perspective on application and benefits and a systematic literature review

Effect of Intravenous Propofol and Inhaled Sevoflurane Anesthesia on Postoperative Spirometric Indices: A Randomized Controlled Trial

Contact Info

Product

Resources

About