Fentanyl???Diazepam Anesthesia with or without N2O Does Not Attenuate Cardiopulmonary Baroreflex-Mediated Vasoconstrictor Responses to Controlled Hypovolemia in Humans

Ebert, Thomas J.; Kotrly, Karel J.; Madsen, Karin E.; Bernstein, Joseph S.; Kampine, John P.

doi:10.1213/00000539-198806000-00009

Cited by 18 publications

(11 citation statements)

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“…Halothane caused a pronounced fall in arterial pressure, but with propofol it fell only at the higher dose, and with alfentanil it rose ( Table 2). These are within the spectrum of effects of these agents that have been reported in man (Eger et al 1970;Sonntag et al 1978;Sebel et al 1982;Rucquoi & Camu 1983;Ebert et al 1985;Sebel & Lowden 1989). The effects of these anaesthetics on left ventricular function in rabbits is not known.…”

Section: Effects On Haemodynamic Variablessupporting

confidence: 56%

“…In man, halothane markedly attenuates the vagal component of the baroreceptor-heart rate reflex (Duke et al 1977), and it attenuates the vasoconstrictor response to a 16-20% fall in cardiac output produced by LBNP (Ebert et al 1985). We found that halothane severely attenuated the baroreceptor-heart rate reflex over its whole range (Fig.…”

Section: Effects On the Response To Acute Central Hypovolaemia And Onsupporting

confidence: 50%

“…This is best tested by making observations within the same subject, first before and then during general anaesthesia. In humans, it has been shown that the haemodynamic response to LBNP is greatly altered by halothane anaesthesia (Ebert et al 1985), but not by fentanyl-diazepam in the presence or absence of nitrous oxide (Ebert et al 1988). However in these studies only the first, compensatory, phase of acute central hypovolaemia was examined.…”

Section: Introductionmentioning

confidence: 99%

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Effects of Halothane, Ketamine, Propofol and Alfentanil Anaesthesia on Circulatory Control in Rabbits

Leeuwen

Evans

Ludbrook

1990

Clin Exp Pharma Physio

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1. We have made a within-rabbit comparison of the effects of four general anaesthetic regimens on the haemodynamic response to acute reduction in central blood volume and on baroreflex control of heart rate. 2. Acute haemorrhage was simulated by gradually inflating a cuff on the inferior vena cava in order to cause cardiac output to fall at a constant rate of 8.5%/min while the responses of systemic vascular resistance, arterial pressure and heart rate were measured. The full range of the baroreceptor-heart rate reflex was elicited by inflating aortic and vena caval cuffs. These indices of circulatory control were repeatedly measured within five protocols, to which each rabbit was exposed in randomized order. 3. In each protocol the rabbit was first studied unanaesthetized. Then a small dose of thiopentone sodium was given (16 mg/kg). In the four main protocols the rabbit was then intubated and ventilated, first with 100% oxygen and then with 50% nitrous oxide, during administration of one of four anaesthetic agents. These were halothane (2.0 and 2.5%), ketamine (2.5 mg/kg per min), propofol (0.83 and 1.25 mg/kg per min) and alfentanil (2.5 and 3.33 micrograms/kg per min). In a sham protocol the effects of 100% oxygen, then those of 50 and 75% nitrous oxide, were studied while the rabbit remained conscious. 4. In unanaesthetized rabbits, in the presence or absence of nitrous oxide, the normal biphasic haemodynamic response to simulated haemorrhage occurred. The first, vasoconstrictor, phase was attenuated by halothane, ketamine and propofol, so that arterial pressure fell more steeply than normal. Not only was the vasoconstrictor phase unaffected by alfentanil but it was extended, so that arterial pressure remained at a normal level even when cardiac output had fallen by 59%. This effect of alfentanil appeared to be mediated centrally, since it could be reproduced by injecting small doses (1.5-7.5 micrograms) into the fourth ventricle. All four anaesthetic agents and nitrous oxide attenuated the baroreceptor control of heart rate. The effect was least with nitrous oxide and alfentanil, greatest with halothane.

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Section: Effects On Haemodynamic Variablessupporting

confidence: 56%

Section: Effects On the Response To Acute Central Hypovolaemia And Onsupporting

confidence: 50%

Section: Introductionmentioning

confidence: 99%

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Effects of Halothane, Ketamine, Propofol and Alfentanil Anaesthesia on Circulatory Control in Rabbits

Leeuwen

Evans

Ludbrook

1990

Clin Exp Pharma Physio

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“…Ayrıca, bu ajanlar; arteriyal barorefleks fonksiyonunu bozarlar. Özellikle primer olarak dolaşımın düşük-basınç tarafında yerleşmiş olan kardiyopulmoner baroreseptörler kardiyak dolum basınçlarındaki ufak azalmaları bile algılayarak periferik vazokonstriksiyon ile intraoperatif hipovolemi sırasında kan basıncının belirli bir düzeyde tutulmasını sağlarlar (16). Opioid bazlı anestezi, inhalasyon ve intravenöz ajanların opioidlerle kombinasyonu bu hastalarda tercih edilmektedir.…”

Section: Discussionunclassified

Our Anaesthetic Experiences in Patients Undergoing Percutaneous Mitraclip Implantation

Erkılıç¹,

Kesimci²,

Döğer³

et al. 2016

Turk J Anaesth Reanim

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“…Durch die Kombination unterschiedlicher Anästhesieverfahren können bei einer sinnvollen Abstimmung der Einzelkomponenten aufeinander die Vorteile des jeweiligen Einzelverfahrens genutzt und dessen Nachteile reduziert werden. Unbestritten ist es aber, daß sowohl eine Kombination von Regional-mit Allgemeinanästhesie im Rahmen einer balancierten Anästhesie, als auch die alleinige hochdosierte Anwendung von Opioiden sowie eine Kombination von intravenösen und volatilen Anästhetika geeignet ist, Risikopatienten sicher zu anästhesieren [2,25,47,144,146,149,182,183]. Die Aufgabe der Epiduralanästhesie (EPA) ist dabei die intraoperative Analgesie mit Unterbrechung des nozizeptiven Reizes.…”

unclassified

Kombinierte Anästhesieverfahren

et al. 1999

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The additive properties of general and regional anesthetic techniques are brought together in combined anesthesia to minimise side effects of the individual techniques. Despite a wide experience with both used as single anesthetic techniques, no definite recommendations regarding indications, general contraindications and procedure exist for their combination. Beneficial effects on haemodynamics, respiratory function, intestinal motility and postoperative stress response have been demonstrated for a combination of general anesthesia and thoracic epidural anesthesia (TEA). In addition TEA is favourable in the management of postoperative pain, which has advantageous effects on convalescence especially in a high risk patient group. Nevertheless, until now no reduction of perioperative morbidity and mortality has been demonstrated. Since the combination of two anesthesia techniques theoretically increases the rate of complication, the expected benefit for the patient must predominate. To estimate the risks and benefits of combined anesthesia, the anesthesiologist must be familiar with each single method, as well as with the synergistic effects of both techniques in order to evaluate the individual indication.

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Fentanyl???Diazepam Anesthesia with or without N2O Does Not Attenuate Cardiopulmonary Baroreflex-Mediated Vasoconstrictor Responses to Controlled Hypovolemia in Humans

Cited by 18 publications

References 0 publications

Effects of Halothane, Ketamine, Propofol and Alfentanil Anaesthesia on Circulatory Control in Rabbits

Effects of Halothane, Ketamine, Propofol and Alfentanil Anaesthesia on Circulatory Control in Rabbits

Our Anaesthetic Experiences in Patients Undergoing Percutaneous Mitraclip Implantation

Kombinierte Anästhesieverfahren

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