Document Detail


Isoflurane, and not halothane, increases mesenteric blood flow supplying esophageal ileocoloplasty.
MedLine Citation:
PMID:  2008951     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Regional ischemia may induce anastomotic leakage or stenosis after esophageal reconstruction using retrosternal interposition of an ileocolic graft. These complications may be related to systemic or local hemodynamic alterations. This study was designed to evaluate the influence of inhalational anesthetic agents on the intestinal circulation supplying these ileocolic grafts. Seven patients (age 30 +/- 5 yr, mean +/- standard deviation [SD]) were studied in the immediate postlaparotomy period. Miniaturized Doppler implantable microprobes were sutured to the single artery supplying the graft and connected to an 8-MHz pulsed Doppler flowmeter. Continuous fentanyl infusion (300 micrograms.h-1) was maintained throughout the study. Measurements were performed at the end of four 30-min periods, which were, successively: first control; isoflurane or halothane anesthesia; second control; and isoflurane or halothane anesthesia. Isoflurane and halothane were administered in cross sequence with end-tidal concentration of 0.8% and 0.5%, respectively, to induce equipotent anesthesia. Both anesthetics induced similar decreases in mean systemic arterial pressure (MAP), cardiac output (CO), and systemic vascular resistance. During isoflurane, mean mesenteric blood flow (MBFm) supplying the graft was increased (+38%; P less than 0.05), and the mesenteric vascular resistance index (MVRI; -44%; P less than 0.05) was decreased, leading to an increase in the MBFm/CO ratio (P less than 0.05). Halothane changed neither the MBFm nor the MBFm/CO ratio, despite a mild decrease in MVRI (-14%; P less than 0.05). Diastolic blood flow velocity increased significantly (2.3 +/- 0.9 vs. 0.8 +/- 0.3 cm.s-1, P less than 0.05) only with isoflurane, suggesting a local vasodilation not observed with halothane.(ABSTRACT TRUNCATED AT 250 WORDS)
Authors:
L Jacob; S Boudaoud; D Payen; O Rabary; E Sarfati; D Gossot; S Villiers; B Eurin
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Anesthesiology     Volume:  74     ISSN:  0003-3022     ISO Abbreviation:  Anesthesiology     Publication Date:  1991 Apr 
Date Detail:
Created Date:  1991-05-02     Completed Date:  1991-05-02     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  1300217     Medline TA:  Anesthesiology     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  699-704     Citation Subset:  AIM; IM    
Affiliation:
Service d'Anesthésiologie-Réanimation Chirurgicale, Hôpital Universitaire Saint-Louis, Paris, France.
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MeSH Terms
Descriptor/Qualifier:
Adult
Colon / surgery
Esophagoplasty*
Esophagus / blood supply,  surgery
Halothane / pharmacology*
Hemodynamics / drug effects*
Humans
Isoflurane / pharmacology*
Postoperative Period
Splanchnic Circulation / drug effects*
Ultrasonics
Chemical
Reg. No./Substance:
151-67-7/Halothane; 26675-46-7/Isoflurane

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


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