Document Detail

Isoflurane and sevoflurane augment norepinephrine responses to surgical noxious stimulation in humans.
MedLine Citation:
PMID:  9856715     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Suppression of hypertensive response to noxious stimulation by volatile anesthetics may be a result of suppression of the stimulation-induced norepinephrine response or that of the cardiovascular response to catecholamines, or both. The suppression of the cardiovascular response is established, but that of norepinephrine response has not been confirmed. The authors hypothesized that the suppression of cardiovascular response but not that of norepinephrine response plays a major role in suppressing the noxious stimulation-induced hypertensive response by volatile anesthetics. METHODS: Forty healthy donors for living-related liver transplantation were allocated to four groups: receiving 1.2% (end-tidal) isoflurane in oxygen and nitrogen, 2.0% isoflurane, 1.7% sevoflurane, or 2.8% sevoflurane. The intraoperative plasma norepinephrine and epinephrine concentrations, arterial blood pressure and pulse rate were measured for the first 15 min of surgery and were compared with the preoperative values. RESULTS: Norepinephrine and epinephrine concentrations both increased intraoperatively in all four groups. The values of maximum increase and area under the concentration-versus-time curve of norepinephrine were greater in the high dose groups of both anesthetics. The intraoperative blood pressure did not differ by different doses of anesthetics, and the degree of increase of blood pressure was not proportional to the plasma catecholamine concentrations. CONCLUSION: The effects of isoflurane and sevoflurane on the surgical noxious stimulation-induced norepinephrine response were inversely proportional to the dose. The suppression of noxious stimulation-induced blood pressure response by anesthetics that were studied may be the result of suppression of the responses of vascular smooth muscle and myocardium to catecholamines.
H Segawa; K Mori; M Murakawa; K Kasai; G Shirakami; T Adachi; T Arai
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Publication Detail:
Type:  Clinical Trial; Controlled Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Anesthesiology     Volume:  89     ISSN:  0003-3022     ISO Abbreviation:  Anesthesiology     Publication Date:  1998 Dec 
Date Detail:
Created Date:  1998-12-31     Completed Date:  1998-12-31     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  1300217     Medline TA:  Anesthesiology     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1407-13     Citation Subset:  AIM; IM    
Department of Anesthesia, Kyoto University Hospital, Japan.
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MeSH Terms
Anesthesia, Inhalation*
Anesthetics, Inhalation*
Blood Pressure / drug effects
Epinephrine / blood
Heart Rate / drug effects
Hemodynamics / drug effects
Liver Transplantation
Living Donors
Methyl Ethers*
Middle Aged
Norepinephrine / blood*
Surgical Procedures, Operative / adverse effects*
Reg. No./Substance:
0/Anesthetics, Inhalation; 0/Methyl Ethers; 26675-46-7/Isoflurane; 28523-86-6/sevoflurane; 51-41-2/Norepinephrine; 51-43-4/Epinephrine
Erratum In:
Anesthesiology 1999 Mar;90(3):937

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

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