Document Detail


Comparison of the effects of sevoflurane and isoflurane anesthesia on the maternal-fetal unit in sheep.
MedLine Citation:
PMID:  19685120     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: The aim of this study was to determine the hemodynamic and blood gas effects of inhalational anesthetics on the maternal-fetal sheep unit. The principal hypothesis, tested in chronically instrumented near-term pregnant ewes, was that sevoflurane anesthesia may be safe and useful for the mother and fetus during pregnancy, compared with isoflurane. METHODS: Six chronically instrumented pregnant and 3 nonpregnant ewes were tested repeatedly to establish the minimum alveolar concentration (MAC) for sevoflurane and isoflurane to be used in the hemodynamic and blood gas studies. Progressively increasing concentrations of sevoflurane or isoflurane in oxygen were administered to 12 pregnant ewes. Uterine blood flow, maternal and fetal heart rates, blood pressure, arterial blood gases, and intra-amniotic pressure were subsequently measured. RESULTS: The MAC of sevoflurane was 1.52 +/- 0.1 15% and 1.92 +/- 0.17% in pregnant and nonpregnant ewes, respectively; while the MAC of isoflurane in the pregnant and nonpregnant sheep was 1.02 +/- 0.12% and 1.42 +/- 0.19%, respectively. In both the sevoflurane and isoflurane groups, changes in maternal and fetal blood gases were minimal during exposure to low-dose (0.5-1.0 MAC) inhaled concentrations. Although uterine blood flow was maintained and the fetus remained well oxygenated at higher concentrations of both agents (2.0 MAC of either agent), the agents produced decreases in maternal and fetal arterial pressure. CONCLUSION: A "low-dose" concentration (0.5-1.0 MAC) of sevoflurane may be safe and useful for both mother and fetus during near-term pregnancy. However, a high concentration (1.5-2.0 MAC) of sevoflurane or isoflurane may induce hemodynamic instability in the mother and fetus when administered.
Authors:
Toshiyuki Okutomi; Robert A Whittington; Deborah J Stein; Hisayo O Morishima
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2009-08-14
Journal Detail:
Title:  Journal of anesthesia     Volume:  23     ISSN:  1438-8359     ISO Abbreviation:  J Anesth     Publication Date:  2009  
Date Detail:
Created Date:  2009-08-17     Completed Date:  2009-12-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8905667     Medline TA:  J Anesth     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  392-8     Citation Subset:  IM    
Affiliation:
Departments of Anesthesiology and Obstetrics/Gynecology, College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA.
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MeSH Terms
Descriptor/Qualifier:
Acid-Base Equilibrium / drug effects
Anesthesia, Inhalation*
Anesthetics, Inhalation*
Animals
Blood Gas Analysis
Blood Pressure / drug effects
Carbon Dioxide / blood
Female
Fetus / drug effects*
Heart Rate, Fetal / drug effects
Hemodynamics / drug effects
Hydrogen-Ion Concentration
Isoflurane*
Methyl Ethers*
Oxygen / blood
Pregnancy
Pulmonary Alveoli / metabolism
Regional Blood Flow / drug effects
Sheep
Uterus / blood supply
Grant Support
ID/Acronym/Agency:
DA 07588/DA/NIDA NIH HHS
Chemical
Reg. No./Substance:
0/Anesthetics, Inhalation; 0/Methyl Ethers; 124-38-9/Carbon Dioxide; 26675-46-7/Isoflurane; 28523-86-6/sevoflurane; 7782-44-7/Oxygen

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


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