Document Detail


Different effects of sevoflurane, desflurane, and isoflurane on early and late left ventricular diastolic function in young healthy adults.
MedLine Citation:
PMID:  20357008     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Knowledge on the effects of volatile anaesthetics on left ventricular (LV) diastolic function in humans in vivo is limited. We tested the hypothesis that sevoflurane, desflurane, and isoflurane do not impair LV diastolic function in young healthy humans. METHODS: Sixty otherwise healthy subjects (aged 18-48 yr) undergoing minor procedures under general anaesthesia were studied. After randomization for the anaesthetic, transthoracic echocardiographic examinations were performed at baseline and under anaesthesia with 1 minimum alveolar concentration (MAC) of the volatile anaesthetics during spontaneous breathing and intermittent positive pressure ventilation (IPPV). Peak early (E') and late (A') diastolic velocities of the mitral annulus were studied as the main echocardiographic indicators of diastolic function. RESULTS: During anaesthesia with 1 MAC under spontaneous breathing, E' increased with desflurane (P<0.001), was not significantly different with isoflurane (P=0.030), and decreased with sevoflurane (P=0.006). During IPPV, E' was similar to baseline with desflurane (P=0.550), insignificantly decreased with isoflurane (P=0.029), and decreased with the sevoflurane group (P<0.001). In contrast, A' was similarly reduced in all groups during spontaneous breathing without further changes during IPPV. Haemodynamic changes were comparable in all study groups. CONCLUSIONS: The findings of this in vivo study indicate that desflurane and isoflurane, and most likely sevoflurane, have no relevant direct negative effect on early diastolic relaxation in young healthy humans. In contrast, all three volatile anaesthetics appear to impair late diastolic LV filling during atrial contraction.
Authors:
D Bolliger; M D Seeberger; J Kasper; A Bernheim; R M Schumann; K Skarvan; P Buser; M Filipovic
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2010-03-31
Journal Detail:
Title:  British journal of anaesthesia     Volume:  104     ISSN:  1471-6771     ISO Abbreviation:  Br J Anaesth     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-04-19     Completed Date:  2010-05-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372541     Medline TA:  Br J Anaesth     Country:  England    
Other Details:
Languages:  eng     Pagination:  547-54     Citation Subset:  IM    
Affiliation:
Department of Anaesthesia and Intensive Care Medicine, University Hospital Basel, CH-4031 Basel, Switzerland. peter.marhofer@meduniwien.ac.at
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Anesthetics, Inhalation / pharmacology*
Echocardiography, Doppler, Pulsed / methods
Female
Humans
Intermittent Positive-Pressure Ventilation
Isoflurane / analogs & derivatives,  pharmacology
Male
Methyl Ethers / pharmacology
Middle Aged
Observer Variation
Respiration
Ventricular Function, Left / drug effects*
Young Adult
Chemical
Reg. No./Substance:
0/Anesthetics, Inhalation; 0/Methyl Ethers; 26675-46-7/Isoflurane; 28523-86-6/sevoflurane; 57041-67-5/desflurane

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


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