The Effect of Surgical Stress on Haemodynamics during Neurolept Anaesthesia

Santesson, J.; Jaernberg, P.; Arnér, Staffan

doi:10.1097/00132586-197906000-00040

Cited by 4 publications

(8 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The fall in T P R following NLA agrees with results in other studies (DIXON et al 1970, SANTESSON et al 1978). There may be several explanations for this decrease.…”

Section: A)supporting

confidence: 91%

“…If the decrease in 0, was caused by a primary myocardial depression, a n increase in AVD would have been expected to compensate for the decrease in total oxygen availability. The unchanged AVD following NLA is in accordance with recent results in surgical patients (BRISMAR et al 1977, SANTESSON et al 1978. The fact that SV and CVP were both unchanged lends further support to the assumption that NLA did not cause any primary depression of cardiac function, which is also in agreement with several studies in the dog , DIXON et al 1970, FREYE 1974, OSTHEIMER et al 1975).…”

Section: A)supporting

confidence: 89%

“…NLA reduced V, , , to about 80%, which is a smaller decrease than reported by GEMPERLE (1965) in the dog and BRISMAR et al (1977) in man, but in agreement with SANTESSON et al (1978). FORBES et al (1967) failed, however, to demonstrate any decrease in '?021.…”

Section: A)supporting

confidence: 48%

“…The main reason for this is the stability of cardiovascular function during NLA, which has been demonstrated in several studies in man (DOBKIN , ZAUDER et al 1965, DOBKIN et al 1970, TARHAN et al 1971, STOELTINC et al 1975. Other studies have shown, however, that NLA may cause moderate cardiovascular depression (MACDONALD , PRYS-ROBERTS & KELMAN 1967, BRISMAR et al 1977, SANTESSON et al 1978. This has also been demonstrated in the dog (DOBKIN et al 1963, YELNOSKY & GARDOCKI 1964, PICHL- MAYR 1969, DIXON et al 1970.…”

mentioning

confidence: 93%

See 3 more Smart Citations

Effects of Neurolept Anaesthesia (NLA) on Haemodynamics and Oxygen Consumption in the Dog with Special Reference to the Liver and Preportal Tissues

Irestedt

Andreen

1979

Acta Anaesthesiol Scand

View full text Add to dashboard Cite

The effects of neurolept anaesthesia (NLA) on central circulation, total oxygen uptake and splanchnic circulation and oxygen uptake were studied in 12 artificially ventilated dogs, basally anaesthetized with thiopental and nitrous oxide. Hepatic arterial, superior mesenteric arterial and portal venous blood flows were measured with electromagnetic flowmetry. Cardiac output was measured by thermodilution. Determinations of oxygen contents were made in arterial, pulmonary arterial, portal venous and hepatic venous blood. NLA was induced with droperidol 0.5 mg . kg-1 b.w. and fentanyl 0.01 mg . kg-1 b.w. Arterial blood pressure decreased to 63% of control value due to reductions of cardiac output to 78% and of total peripheral vascular resistance to 81% of control values. Hepatic arterial, superior mesenteric arterial and portal venous blood flows all diminished to 75% of control values. Hepatic arterial, superior mesenteric arterial and preportal tissue vascular resistances all decreased. Total oxygen uptake declined to the same extent as cardiac output, leaving the arterio-venous oxygen difference unchanged. Oxygen uptake of the preportal tissues was unaffected and hepatic oxygen uptake was not significantly reduced, although there were decreases of hepatic oxygen uptake in some of the individual dogs. It is suggested that the cardiovascular depression following NLA was due to adaptation to a lowered total oxygen uptake. It is further concluded that splanchnic circulation was well preserved due to decreases in splanchnic vascular resistances, and that splanchnic oxygen consumption was maintained by means of increased oxygen extraction.

show abstract

“…The fall in T P R following NLA agrees with results in other studies (DIXON et al 1970, SANTESSON et al 1978). There may be several explanations for this decrease.…”

Section: A)supporting

confidence: 91%

Section: A)supporting

confidence: 89%

Section: A)supporting

confidence: 48%

mentioning

confidence: 93%

See 2 more Smart Citations

Effects of Neurolept Anaesthesia (NLA) on Haemodynamics and Oxygen Consumption in the Dog with Special Reference to the Liver and Preportal Tissues

Irestedt

Andreen

1979

Acta Anaesthesiol Scand

View full text Add to dashboard Cite

show abstract

“…The total body oxygen uptake is reduced by 20-40% by general anesthesia. 26,27 Several studies have been made on the effects of different anesthetics on hormones, as well as on blood glucose. Thus, it has been found that thiopental in combination with nitrous oxide/oxygen does not influence blood sugar.4, 28, 29 Anesthesia with droperidol, fentanyl, and nitrous oxide in oxygen for 1 hr does not alter the adrenaline and noradrenaline levels.…”

Section: Resultsmentioning

confidence: 99%

The Influence of Abdominal Surgical Trauma Upon the Turnover of Some Blood‐Borne Energy Metabolites in the Human Leg

Stjernström

Jorfeldt

Wiklund

1981

J Parenter Enteral Nutr

View full text Add to dashboard Cite

A moderate elevation of blood sugar and a reduction of glucose tolerance occur in association with surgical trauma. This may be due to an increased release of glucose from the liver or a reduced peripheral uptake of glucose, or both. The present study was undertaken to investigate the peripheral exchanges of energy substrates. Twenty-six patients undergoing cholecystectomy underwent turnover studies on blood-borne energy substrates in the leg before, during, and immediately after surgery. Measurements of leg blood flow and femoral arteriovenous differences in oxygen, glucose, lactate, pyruvate, glycerol, β-hydroxybutyrate, and alanine were made. After induction of general anesthesia, leg oxygen uptake decreased by 34%. Postoperatively, the oxygen uptake was 150% higher than the preanaesthetic level. During surgery, leg blood flow did not change significantly, but postoperatively it was increased by 50%. Arterial blood glucose concentration increased about 1 mmol/liter hr during the operation. Glucose uptake in the leg did not change significantly, although a large number of negative arteriovenous differences were obtained towards the end of surgery. Assimilated glucose was estimated to have accounted for 7% of the leg oxygen uptake before surgery. Toward the end of surgery, and in the immediate postoperative period, lactate release exceeded glucose uptake. During surgery, lactate and pyruvate release from the leg increased. Alanine release was also increased towards the end of the operation. As judged by the raised free fatty acids, glycerol, and β-hydroxybutyrate levels, lipolysis was stimulated during surgery. There was a correlation between leg uptake and arterial concentration of β-hydroxybutyrate. It is suggested that the increased lipolysis and increased uptake of β-hydroxybutyrate contribute to the low glucose utilization during surgery. Surgical trauma is accompanied by changes in human energy turnover and metabolism. 1&dquo; The magnitude of the metabolic changes is related to the type and duration of surgery and anaesthesia. A modest elevation of blood sugar occurs in association with surgical operations.' Upper intra-abdominal surgery produces a larger hyperglycaemic response than body surface or thoracic surgery.4 It is not clear, however, whether this hyperglycemia is due to an increased splanchnic release of glucose or a decreased peripheral utilization, or both. The peripheral glucose uptake is claimed to be reduced in connection with surgery,&dquo; ' 6 but definite proof of this assertion has been lacking. The splanchnic release of glucose is gradually decreased 1-2 hr after an uncomplicated upper abdominal operation.~ No data are available, however, on the turnover of energy substrates in the periphery in the intra-operative and immediate postoperative period. In the present study, the peripheral energy metabolism before, during, and immediately after abdominal surgery was investigated, by measuring leg blood flow, leg oxygen uptake, and the femoral arteriovenous differences o...

show abstract

Effect of Neurolept and Epidural Analgesia on Cardiovascular Function and Tissue Metabolism in the Geriatric Patient

Stefánsson

Wickström

Haljamäe

1982

Acta Anaesthesiol Scand

View full text Add to dashboard Cite

The cardiovascular and metabolic effects of neurolept (NLA) and epidural analgesia were studied in geriatric patients (n=16, mean age 83 and 84 years, respectively) with hip fractures. Measurements were performed before premedication, at the end of operation as well as 15 min and 2 h after the end of anesthesia. During anesthesia and surgery no significant changes were seen in the studied hemodynamic variables (systemic and pulmonary arterial, central venous and pulmonary capillary wedge pressures, heart rate, cardiac index, stroke volume index, pulmonary and systemic vascular resistances) in either group. Fifteen minutes after the end of anesthesia cardiac index and heart rate rose in the NLA group while no changes were seen in the epidural group. During anesthesia and surgery, arterial oxygen tension (PaO2) increased in both groups due to increased inspired oxygen fraction. In the NLA group, arterial carbon dioxide tension (PacO2) was decreased due to the mechanical ventilation, and a slight decrease in arterial base excess (BEa) was also seen. A similar decrease in Bea occurred in the epidural group. In the postoperative period, PaCO2 increased and pH and BEa decrease significantly in the NLA group, while the only change seen in the epidural group was a slightly low BEa level. Blood glucose. lactate and pyruvate levels increased to a similar extent in both groups during anesthesia and surgery. However, in the postoperative period these levels continued to increase in the NLA group while partial normalization was seen in the epidural group. The lactate levels in skeletal muscle were increased in both groups during the postoperative period. Glucose‐6‐phosphate levels were increased during surgery and in the postoperative period only in the NLA group. No changes were seen in high energy phosphagen levels of skeletal muscle in either group during the studied time period. With the techniques used in the present study epidural analgesia as there are less hemodynamic, respiratory and metabolic effect in postoperative period.

show abstract

The Effect of Surgical Stress on Haemodynamics during Neurolept Anaesthesia

Cited by 4 publications

References 7 publications

Effects of Neurolept Anaesthesia (NLA) on Haemodynamics and Oxygen Consumption in the Dog with Special Reference to the Liver and Preportal Tissues

Effects of Neurolept Anaesthesia (NLA) on Haemodynamics and Oxygen Consumption in the Dog with Special Reference to the Liver and Preportal Tissues

The Influence of Abdominal Surgical Trauma Upon the Turnover of Some Blood‐Borne Energy Metabolites in the Human Leg

Effect of Neurolept and Epidural Analgesia on Cardiovascular Function and Tissue Metabolism in the Geriatric Patient

Contact Info

Product

Resources

About