Effect of catecholamine depletion on increased blood pressure lability upon emergence from halothane anesthesia in rats: the role of sympathetic nervous activity in postanesthetic circulatory instability.
OBJECTIVE
Circulatory instability is often observed upon emergence from general anesthesia. The increased blood pressure (BP) lability has been associated with poor clinical outcome. However, its underlying mechanisms are not fully understood. Thus, we investigated a possible role of the sympathetic nervous system (SNS) and cardiac baroreflex in the increased pressure lability observed upon emergence from general anesthesia.


METHODS
Male rats (n = 16) were allocated to two groups, i.e., (1) a control group (n = 8) and (2) an alpha-methylparatyrosine (alpha-MPT; an inhibitor of tyrosine hydroxylase)-treated group (n = 8). In the alpha-MPT-treated group, in order to deplete catecholamines both in the central nervous system and in the SNS, alpha-MPT (300 mg x kg(-1)) was injected intraperitoneally (i.p.), administered twice, 4 and 2 h before halothane discontinuation (total dose, 600 mg x kg(-1) i.p.). In the control group, saline was administered at identical time-points. Systolic BP (SBP) lability was evaluated on a beat-by-beat basis, using the coefficient of variation of SBP, and the occurrence of slow and rapid rises in SBP and their amplitude, while the cardiac baroreflex slope was calculated using the "sequences" method.


RESULTS
In the control group, heart rate, SBP, and the three indices of BP lability (i.e., the 3 indices of BP lability are: coefficient of variation of SBP, number of slow and rapid rises in pressure, amplitude of slow and rapid rises in pressure) all increased upon emergence from anesthesia (P < 0.05). Such increases were all blunted in the alpha-MPT-treated group, with the increases in the three indices of BP lability almost entirely suppressed (P < 0.05). The cardiac baroreflex slope was similarly decreased in both groups (P < 0.05).


CONCLUSIONS
The postanesthetic increase in pressure lability seems largely a consequence of increased sympathetic activity, irrespective of any change in cardiac baroreflex sensitivity.
Cividjian
Andrei
A
Physiology, CNRS 5123-University of Lyon 1, Lyon-Villeurbanne, Lyon, France.
Rentero
Nicolas
N
Pequignot
Jean Marc
JM
Quintin
Luc
L
D000762:Anesthesia Recovery Period; D018685:Anesthetics, Inhalation; D000818:Animals; D017704:Baroreflex / Q000187:drug effects / Q000502:physiology; D001794:Blood Pressure / Q000187:drug effects* / Q000502:physiology; D002395:Catecholamines / Q000172:deficiency*; D002985:Clinical Protocols; D004791:Enzyme Inhibitors / Q000494:pharmacology; D006221:Halothane; D008297:Male; D051381:Rats; D017207:Rats, Sprague-Dawley; D013564:Sympathetic Nervous System / Q000187:drug effects* / Q000502:physiology; D014666:Vasomotor System / Q000187:drug effects / Q000502:physiology; D019805:alpha-Methyltyrosine / Q000494:pharmacology
D018685:Anesthetics, Inhalation; D002395:Catecholamines; D004791:Enzyme Inhibitors; D019805:alpha-Methyltyrosine; D006221:Halothane