Peripheral blood flow in the elderly during inhalational anaesthesia.
We investigated whether aging altered the peripheral vascular effects of inhaled anaesthetic agents. Forearm blood flow (FBF) was measured in 20 young (18-34 yrs) and 21 healthy elderly (60-79) patients receiving isoflurane or halothane with 66% nitrous oxide (N2O) in oxygen (O2). After etomidate 0.3 mg/kg and vecuronium 0.1 mg/kg, the trachea was intubated and controlled ventilation instituted with 66% N2O in O2. Halothane or isoflurane were administered to achieve end-tidal concentrations of 0.5% halothane or 0.9% isoflurane after 20 min. FBF was measured by venous occlusion plethysmography during the 20 min study period. Induction of anaesthesia with etomidate decreased FBF below baseline (awake) values in both elderly and young; intubation returned FBF to baseline values in the young but not in the elderly. FBF decreased below baseline values in young and elderly patients receiving halothane and in elderly patients receiving isoflurane but not in young patients receiving isoflurane. FBF was significantly greater in young patients receiving isoflurane than halothane after 20 min administration. We conclude that perfusion of forearm muscle and skin is maintained in the young but not in the elderly during anaesthesia with isoflurane/N2O. Perfusion of forearm muscle and skin decreases in both young and elderly patients during anaesthesia with halothane/N2O. The cardiovascular effects of isoflurane/N2O and halothane/N2O did not differ significantly in healthy elderly patients.
Dwyer
R
R
Department of Anaesthetics, Queens University, Belfast, Northern Ireland.
Howe
J
J
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000769:Anesthesia, Inhalation; D018685:Anesthetics, Inhalation / Q000494:pharmacology*; D001783:Blood Flow Velocity / Q000187:drug effects; D001794:Blood Pressure / Q000187:drug effects; D005045:Etomidate; D005260:Female; D005542:Forearm / Q000098:blood supply*; D006221:Halothane; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007530:Isoflurane; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000098:blood supply; D010991:Plethysmography; D012039:Regional Blood Flow / Q000187:drug effects; D012867:Skin / Q000098:blood supply; D014655:Vascular Resistance / Q000187:drug effects
D018685:Anesthetics, Inhalation; D007530:Isoflurane; D006221:Halothane; D005045:Etomidate