Document Detail


Autonomic activity during desflurane anesthesia in patients with brain tumors.
MedLine Citation:
PMID:  17641979     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Although intracranial tumors may affect autonomic function, there are few reports of autonomic changes during anesthesia. The purpose of this study was to evaluate autonomic effects of anesthesia in patients with brain tumors compared to neurosurgical controls. METHODS: Two groups were evaluated: group 1 = 10 neurosurgical patients undergoing spinal cord surgery, group 2 = 10 patients with intracranial tumors. After placement of electrocardiogram and Response Entropy electroencephalogram (EEG) electrodes, 10 min baseline measures were made. Heart periods were transformed into a percentage index and heart rate entropy determined as a measure of variance of autonomic activity. Tone was evaluated as the balance between accelerator and inhibitory activity. Tone-entropy was measured during propofol anesthetic induction and the first 60 min of desflurane anesthesia before the start of surgery. RESULTS: Blood pressure and heart rate were similar between the groups. Starting at awake levels, vagal heart tone was observed. Anesthesia decreased vagal dominance to near zero in both groups. Heart rate entropy and EEG activity decreased during anesthesia with no significant difference between the groups. Desflurane concentrations required to maintain anesthesia were significantly lower in patients in brain tumors. CONCLUSION: Tone-entropy analysis of heart rate indicates anesthetic related depression of autonomic activity with no difference between groups. Normal titration of desflurane concentrations to maintain adequate blood pressure produced desflurane requirements that were lower in patients with brain tumors, while autonomic and EEG activity were similar.
Authors:
Chanannait Paisansathan; William E Hoffman; Michael Lee; Ranga C Ananda; Peggy Wheeler
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Publication Detail:
Type:  Journal Article     Date:  2007-07-20
Journal Detail:
Title:  Journal of clinical monitoring and computing     Volume:  21     ISSN:  1387-1307     ISO Abbreviation:  J Clin Monit Comput     Publication Date:  2007 Oct 
Date Detail:
Created Date:  2007-09-10     Completed Date:  2008-01-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9806357     Medline TA:  J Clin Monit Comput     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  265-9     Citation Subset:  IM    
Affiliation:
Department of Anesthesiology, University of Illinois at Chicago, 1740 W Taylor, Suite 3200, Chicago, IL 60612, USA. oon@uic.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Anesthesia, Inhalation / adverse effects
Anesthetics, Inhalation / administration & dosage*
Autonomic Nervous System / drug effects*,  physiopathology*
Blood Pressure / drug effects
Brain Neoplasms / physiopathology*,  surgery
Case-Control Studies
Electroencephalography
Heart Rate / drug effects
Humans
Isoflurane / administration & dosage,  analogs & derivatives*
Middle Aged
Chemical
Reg. No./Substance:
0/Anesthetics, Inhalation; 26675-46-7/Isoflurane; 57041-67-5/desflurane

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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