Comparison of the haemodynamic actions of desflurane/N 2 O and isoflurane/N 2 O anaesthesia in vascular surgical patients

• Published in: Acta anaesthesiologica Scandinavica Vol. 42; no. 9; pp. 1057 - 1062
• Main Authors: Zubicki, A., Gostin, X., Miclea, D., Rrou, B., Buy, E., Richer, C., Coriat, P.
• Format: Journal Article
• Language: English
• Published: 01-10-1998
• ISSN: 0001-5172; 1399-6576
• DOI: 10.1111/j.1399-6576.1998.tb05376.x

Background:
The purpose of this study was to compare heart rate and arterial blood pressure response to desflurane/N
2
O vs isoflurane/N
2
O anaesthesia in a randomised clinical trial performed in patients before vascular surgery.
Methods:
To evaluate associated changes in the autonomic nervous system with maintenance of anaesthesia, we used power spectral analysis (PSA) of heart rate and blood pressure and measured plasma catecholamine concentrations. Twenty‐five patients whose trachea had been intubated after propofol induction were given either desflurane or isoflurane at 1 and 1.5 MAC in N
2
O (60%) in a random manner.
Results:
At an anaesthetic depth of up to 1.5 MAC, arterial blood pressure, indices of sympathetic activity derived from PSA, decreased with both anaesthetics, while heart rate and plasma catecholamine concentrations did not significantly change. Plasma renin activity significantly increased at 1.5 MAC anaesthesia in both groups.
Conclusions:
We conclude that sympathetic hyperactivity previously reported during desflurane anaesthesia in healthy volunteers is not frequent in clinical practice in elderly vascular surgical patients under desflurane/N
2
O anaesthesia, since it occurs at an anaesthetic depth which cannot be reached in these patients because of the lowering arterial blood pressure effects of desflurane, which are similar to those of isoflurane.