Pharmacokinetics of desflurane uptake into the brain and body

Abstract

SummaryThe aim of this study was to investigate the pharmacokinetics of desflurane uptake into the brain and body by comparing desflurane concentrations in internal jugular-bulb blood (Jdes), arterial blood (Ades) and pulmonary arterial blood (PAdes) at a fixed inspired desflurane concentration. Thirteen patients (aged 42-72 years) undergoing coronary artery bypass grafting surgery were enrolled in this study. They were anaesthetised using a constant 5% inspired desflurane concentration (C I des) during the first hour of anaesthesia. Under constant volume-controlled ventilation, C I des and end-tidal desflurane (C E des) were measured with an infrared analyser. The desflurane concentration in the blood was analysed using gas chromatography, and cardiac output was measured using an Opti-Q pulmonary artery catheter. It took 24 min for the Jdes to equilibrate with Ades. Both C I des-C E des and Ades-PAdes gradients persisted during the study period. There was no further uptake of desflurane into the brain after 24 min but there was near-constant uptake into the body.

Pharmacokinetics of Isoflurane in Human Blood

“…A 2% inspired concentration of isoflurane in 6,000 ml min -1 oxygen flow was administered to wash in functional residual capacity for 5 min, and then the oxygen flow rate was reduced to 300 ml min -1 for the maintenance of minimal-low-flow anesthesia [9,10] , which provided 1.5-2.5% inspired isoflurane concentration according to the dynamic status and the surgical stimuli. After intubation, a single-lumen central venous catheter and a pulmonary arterial catheter were inserted into the right internal jugular bulb and pulmonary artery, respectively, for blood sampling [5,6,11,12] . The cardiopulmonary bypass (CPB) set up was uniform for all patients, namely with a crystalloid prime, a Medtronic membrane oxygenator, moderate hypothermia (28 ° C), hemodilution to a hematocrit of 20-25%, and alpha stat pH management.…”

“…An esophageal thermistor was applied to measure body temperature, which was maintained at 35.5-37.5 ° C during the study. Cardiac output was continuously measured using the Opti-Q catheter (Abbott Critical Care System, Mountain View, Calif., USA) with the Q-Vue continuous cardiac output computer (Abbott Critical Care System) [11,12] .…”

Desfluran und Isofluran bei Niedrigflussnarkosen

“…Die Ergebnisse der vorliegenden Untersuchung können folgendermaßen be- [12,13] untersuchten die zerebrale Äquilibrierung, indem sie die arterielle mit der jugularvenösen Desflurankonzentration verglichen. Ein Gleichgewicht wurde für Desfluran nach 25 min [13] und für Isofluran nach 40 min erreicht [12].…”

“…Ein Gleichgewicht wurde für Desfluran nach 25 min [13] und für Isofluran nach 40 min erreicht [12]. In der hier vorliegenden Untersuchung wurde für Desfluran nach 25 min eine konstante Aufnahme erreicht; dagegen zeigte sich in der Isoflurangruppe eine weitere Aufnahme im zeitlichen Verlauf.…”

Arterial blood concentration of sevoflurane during single-breath induction and tracheal intubation in gynecologic patients

“…The blood concentrations and uptake into the body and brain of volatile anesthetics were determined in our previous studies [8][9][10][11]. However, there are no available data regarding blood concentrations of sevoflurane on loss of consciousness using the single-breath vital capacity technique.…”