[Effects of hypotension induced by isoflurane on hemodynamics and plasma beta 2 microglobulins and creatinine during cerebral aneurysm operation].
OBJECTIVE
To investigate the effects of isoflurane-induced hypotension on the hemodynamics and the changes of plasma beta 2 microglobulins and creatine during cerebral aneurysm operation.


METHODS
Thirty-two cerebral anuerysm patients were operated under general anesthesia. Anesthesia was induced with droperidol, fentayl, sodium pentothal and pavolon intravenously. After tracheal intubation, the isoflurane was inhalated to maintain anesthesia. The concentration of isoflurane was elevated to reduce MAP by 30%-40% during dissection and occlusion of tumor and the level maintained for 30-45 min. Hemodynamic values were measured with Swan-Ganz technique. The hemodynamic parameters(CO, CI, SV, SI, SVR, LVSWI, RVSWI, CVP, CPP, RPP and HR) which were measured with Swan-Ganz technique before, during and after isoflurane-induced hypotension were compared. Blood samples were drawn in given time intervals to determine the concentration of plasma beta 2 Microglobulins(beta 2 MG) by radioimmunoassay. Changes in hemodynamics and the plasma beta 2 MG and creatinine (Cr) after deliberate hypotension of isoflurane were recorded at the same time.


RESULTS
No significant changes of CO, CI, SV, SI, RVSWI, CVP, HR and ECG tracing were observed during hypotension (P > 0.05). SVR, PVR, LVSWI, Cpp and Rpp were significantly decreased during hypotension (P < 0.05), but the risk of myocardial ischemia and deoxygenation was not increased. No effect was found on the plasma beta 2 MG and Cr during isoflurane-induced hypotension in patients undergoing cerebral aneurysm cling operation.


CONCLUSIONS
Hypotension induced by isoflurane during cerebral aneurysm operation is able to keep a good balance of myocardial oxygen delivery and consumption, and keep a good myocardial function.
Wang
J
J
Department of Anesthesiology, First Affiliated Hospital of WenZhou Medical College, Wenzhou 325000.
Lin
J
J
Lin
H
H
D003404:Creatinine / Q000097:blood*; D006439:Hemodynamics; D006801:Humans; D007023:Hypotension, Controlled; D002532:Intracranial Aneurysm / Q000097:blood / Q000503:physiopathology / Q000601:surgery*; D007530:Isoflurane / Q000627:therapeutic use*; D008875:Middle Aged; D009206:Myocardium / Q000378:metabolism; D010101:Oxygen Consumption; D001613:beta 2-Microglobulin / Q000097:blood*
D001613:beta 2-Microglobulin; D003404:Creatinine; D007530:Isoflurane