Response of lower esophageal contractility to changing concentrations of halothane or isoflurane: a multicenter study.
A multiple-center study was performed to determine the relationship between lower esophageal contractility, clinical signs, and anesthetic concentration as expressed by minimum alveolar concentration (MAC). One hundred four American Society of Anesthesiologists Class I through III patients were exposed to isoflurane (with and without nitrous oxide) or halothane in concentrations of 0.5, 1.0, and 1.5 MAC. Heart rate and systolic blood pressure were continuously monitored. Both the amplitude and frequency of spontaneous and provoked lower esophageal contractions were measured in situ by using a 24-F probe equipped with provoking and measuring balloons. Combined results demonstrated statistically significant correlations (P less than 0.001) between lower esophageal contractility and MAC. Spontaneous lower esophageal contractions decreased from 1.10 +/- 0.12 (SEM) contractions per minute (0.5 MAC) to 0.42 +/- 0.05 (1 MAC) to 0.18 +/- 0.05 (1.5 MAC). Provoked lower esophageal contractility values decreased from 45 +/- 4 mm Hg (0.5 MAC) to 29 +/- 3 (1 MAC) to 19 +/- 2 (1.5 MAC). Heart rate changes did not correlate with MAC, and systolic blood pressure correlated in only one of three centers. Intracenter and intercenter analyses failed to demonstrate a significant relationship between lower esophageal contractility and heart rate or systolic blood pressure. No intracenter differences in either amplitude or frequency of lower esophageal contractions were observed, despite differences in volatile agents, induction techniques and agents, patient populations, and durations of anesthesia.(ABSTRACT TRUNCATED AT 250 WORDS)
Maccioli
G A
GA
Department of Anesthesiology, University of North Carolina School of Medicine, Chapel Hill.
Kuni
D R
DR
Silvay
G
G
Evans
J M
JM
Calkins
J M
JM
Kaplan
J A
JA
D000293:Adolescent; D000328:Adult; D000368:Aged; D000769:Anesthesia, Inhalation; D004947:Esophagus / Q000502:physiology*; D005260:Female; D006221:Halothane / Q000008:administration & dosage*; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D007530:Isoflurane / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D015337:Multicenter Studies as Topic; D010528:Peristalsis; D011650:Pulmonary Alveoli / Q000032:analysis; D011897:Random Allocation
D007530:Isoflurane; D006221:Halothane