The Independent Metabolic Effects of Halothane and Isoflurane Anaesthesia

Abstract

Twelve healthy, unpremedicated women scheduled for total abdominal hysterectomy were given either isoflurane (n = 6) or halothane (n = 6) anaesthesia. They all received general anaesthesia for a period of 3 h, with surgery being carried out only in the last hour. The anaesthesia consisted of thiopentone, pancuronium and a mixture of oxygen-enriched air (Fio,=34%) supplemented with 1 MAC of either isoflurane or halothane. The patients were maintained normothermic, and with an arterial Sao, above 95% throughout the period of the study. The following measurements were made before, during and after anaesthesia (with and without surgery): oxygen consumption (oo,), carbon dioxide production (%'GO,); circulating concentrations of various hormones (insulin, growth hormone and cortisol); various metabolites; selected amino acids and albumin; forearm arterio-venous concentration difference of glucose, lactate, free fatty-acids and selected amino acids (four patients in each group). Whole body 00, decreased significantly by over 20% during anaesthesia (with or without surgery), P i 0.05). Although the circulating concentration of most amino acids showed little or no change during anaesthesia alone, there was a tendency for the flux of most metabolites to decrease, and this persisted during surgery (PC0.05). During anaesthesia alone there was a twofold reduction in the plasma cortisol concentration (P< 0.05), and a decrease in albumin concentration (P< 0.01). With the onset of surgery, plasma cortisol concentration increased rapidly (in association with several other hormones and metabolites) but hypoalbuminemia persisted.Receiued I4 34, accepted in a revised version 28 December 1992

Depth of anesthesia with desflurane does not influence the endocrine‐metabolic response to pelvic surgery

“…Calculation for sample size was based on a previous study in the same population undergoing general anesthesia for TAH (12). Ten subjects in each group would be sufficient to detect a reduction in plasma cortisol of 200 mmol/l between the deep and light groups (SD 190 nmol/l), with a type 1 error of 0.05 and a power of 80%.…”

Neuroendocrine stress response in gynecological laparoscopy: TIVA with propofol versus sevoflurane anesthesia

“…The effects of inhalational anesthesia [14,16,17], propofol anesthesia [18,19], and total intravenous anesthesia (TIVA) [15,20] on modulation of neurohumoral response to surgical trauma have been studied, but some aspects are still unclear. The effect of TIVA with propofol and remifentanil on the hypothalamopituitary-adrenal response, on prolactin, growth hormone, and catecholamine release, and on the hypothalamopituitary-thyroid axis has not been assessed.…”

The effects of general anaesthesia on oxygen consumption: A meta‐analysis guiding future studies on perioperative oxygen transport

“…Data from a total of 24 studies including 32 study groups were extracted for quantitative synthesis and meta‐analysis as presented in Table . There were seven randomized studies and 17 studies with a before‐after design.…”