| Comparison of the effects of sevoflurane and isoflurane anesthesia on the maternal-fetal unit in sheep. | |
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MedLine Citation:
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PMID: 19685120 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Toshiyuki Okutomi; Robert A Whittington; Deborah J Stein; Hisayo O Morishima |
Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't Date: 2009-08-14 |
Journal Detail:
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Title: Journal of anesthesia Volume: 23 ISSN: 1438-8359 ISO Abbreviation: J Anesth Publication Date: 2009 |
Date Detail:
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Created Date: 2009-08-17 Completed Date: 2009-12-07 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8905667 Medline TA: J Anesth Country: Japan |
Other Details:
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Languages: eng Pagination: 392-8 Citation Subset: IM |
Affiliation:
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Departments of Anesthesiology and Obstetrics/Gynecology, College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Acid-Base Equilibrium
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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:
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DA 07588/DA/NIDA NIH HHS |
| Chemical | |
Reg. No./Substance:
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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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