[Cardiovascular effects of the new inhalation anaesthetic isoflurane in man (author's transl)].
Cardiovascular responses to isoflurane (forane)-nitrous oxide-oxygen anaesthesia were studied in seven older premedicated patients. Anaesthesia was induced with the new non-barbiturate induction agen etomidate. All patients were intubated and mechanically ventilated to maintain normal PaCO2. Clinical concentrations of isoflurane (0.75 and 1.5 vol.-% inspiratory) decreased mean arterial pressure 22%-42%. Only small reductions in cardiac output and stroke volume were seen. Heart rate, central venous and pulmonary artery pressure remained nearly unaffected. The major cause of the arterial hypotension was a fall in total peripheral resistance by 36% as anaesthesia deepened. Left ventricular maximum dp/dt and load data indicated that isoflurane also possesses negative inotropic properties. Tension-time-index and total body oxygen consumption decreased by 47% and 20% respectively. AVDO2 values remained within the normal range. We take this to mean that the oxygen supply was adequate to meet the metabolic demands of the body as a whole. This was corroborated by the finding that base excess did not change significantly. Conclusions considering the use of isoflurane in patients with diminished cardiovascular reserve are drawn.
D000328:Adult; D000368:Aged; D001794:Blood Pressure / Q000187:drug effects; D002200:Capillary Resistance / Q000187:drug effects; D002302:Cardiac Output / Q000187:drug effects; D002319:Cardiovascular System / Q000187:drug effects*; D002496:Central Venous Pressure / Q000187:drug effects; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007442:Intubation, Intratracheal; D007530:Isoflurane / Q000494:pharmacology*; D008738:Methyl Ethers / Q000494:pharmacology*; D008875:Middle Aged; D009609:Nitrous Oxide; D010100:Oxygen; D010101:Oxygen Consumption / Q000187:drug effects; D011651:Pulmonary Artery
D008738:Methyl Ethers; D007530:Isoflurane; D009609:Nitrous Oxide; D010100:Oxygen
Kreislaufwirkungen des neuen Inhalationsanaesthetikums Isofluran (Forane) beim Menschen