Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1590/S0034-70942003000400006
Brazilian Journal of Anesthesiology
Artigo Científico

Efeitos do halotano, isoflurano e sevoflurano nas respostas cardiovasculares ao pinçamento aórtico infra-renal: estudo experimental em cães

Effects of halothane, isoflurane and sevoflurane on cardiovascular responses to infrarenal aortic cross-clamping: experimental study in dogs

Flora Margarida Barra Bisinotto; José Reinaldo Cerqueira Braz

Downloads: 0
Views: 989

Resumo

JUSTIFICATIVA E OBJETIVOS: O pinçamento infra-renal da aorta abdominal pode produzir alterações hemodinâmicas. O objetivo do estudo foi avaliar os efeitos do halotano, isoflurano e sevoflurano sobre a função cardiovascular, em cães submetidos à pinçamento aórtico infra-renal. MÉTODO: O estudo aleatório foi realizado em 30 cães, distribuídos em três grupos, de acordo com o anestésico halogenado utilizado durante a anestesia, em concentrações equipotentes de 0,75 CAM: GH (n=10) - halotano a 0,67%; GI (n=10) - isoflurano a 0,96%; e GS (n=10) - sevoflurano a 1,8%. Em todos os animais foi realizada ligadura infra-renal da aorta, por período de 30 min. Os atributos hemodinâmicos foram estudados nos momentos: C (Controle), Ao15 e Ao30, respectivamente após 15 e 30 minutos do pinçamento aórtico, e DAo e DAo15, respectivamente, imediatamente e após 15 min do despinçamento aórtico. RESULTADOS: Durante o pinçamento aórtico houve, em todos os grupos, aumento das pressões arterial média e do átrio direito, e dos índices cardíaco, sistólico e de trabalho sistólico dos ventrículos direito e esquerdo. A pressão da artéria pulmonar aumentou em GI e GS e a pressão pulmonar ocluída em GH e GI. Após o despinçamento aórtico, houve normalização dos atributos que haviam se elevado, com exceção dos índices cardíaco e sistólico, que continuaram elevados, acompanhados de diminuição do índice de resistência vascular sistêmica. Não houve diferença significante entre os grupos em relação aos atributos estudados, com exceção da freqüência cardíaca que foi sempre menor em GH, em relação aos demais grupos, durante o pinçamento e despinçamento aórtico. CONCLUSÕES: No cão, nas condições experimentais empregadas, a inalação do halotano, isoflurano e sevoflurano em concentrações equipotentes (0,75 CAM) não atenua as respostas cardiovasculares ao pinçamento aórtico infra-renal.

Palavras-chave

ANESTÉSICOS, ANESTÉSICOS, ANESTÉSICOS, ANESTÉSICOS, ANIMAL, CIRURGIA, CIRURGIA

Abstract

BACKGROUND AND OBJECTIVES: Infrarenal aortic cross-clamping is associated to cardiovascular effects. This study aimed at analyzing the effects of halothane, isoflurane and sevoflurane on cardiovascular function of dogs following infrarenal aortic cross-clamping. METHODS: Thirty mongrel dogs were randomly divided in three groups, according to equipotent (0.75 MAC) inhaled anesthetic doses: GH (n = 10) - 0.67% halothane; GI (n = 10) - 0.96% isoflurane; and GS (n = 10) - 1.8% sevoflurane. All dogs were submitted to infrarenal aortic cross-clamping for 30 minutes. Hemodynamic parameters were measured at control (C), at 15 (Ao15) and 30 (Ao30) minutes of aortic cross-clamping, and immediately (DAo) and 15 (DAo15) minutes after aortic unclamping. RESULTS: In all groups, infrarenal aortic cross-clamping significantly increased mean blood pressure, right atrial pressure, cardiac index, stroke volume index, left ventricular work index and right ventricular work index. Pulmonary artery pressure significantly increased during cross-clamping in GI and GS groups while pulmonary capillary wedge pressure significantly increased in GH and GI groups. After aortic unclamping all hemodynamic parameters have returned to control levels with the exception of cardiac and stroke volume indices which remained high, followed by systemic vascular resistance index decrease. There have been no significant differences among groups in studied attributes, except for heart rate which was always lower in GH group as compared to other groups during and after infrarenal aortic cross-clamping. CONCLUSIONS: In dogs under our experimental conditions, equipotent concentrations (0.75 MAC) of inhalational halothane, isoflurane and sevoflurane have not attenuated cardiovascular responses to infrarenal aortic cross-clamping.

Keywords

ANESTHETICS, ANESTHETICS, ANESTHETICS, ANESTHETICS, ANIMAL, SURGERY, SURGERY

Referências

Haimovici H. Aneurisma de la Aorta Abdominal. Cirugia Vascular - Principios y Tecnicas. 1986:656-707.

Gelman S. The pathophysiology of aortic cross-clamping and unclamping. Anesthesiology. 1995;82:1026-1060.

Jamieson WRE, Janusz MT, Miyagishima RT. Influence of ischemic heart disease on early and late mortality after surgery for peripheral occlusive vascular disease. Circulation. 1982;66(^sI):92-97.

Colson P, Capdevilla X, Balert H. Effects of halothane and isoflurane on transient renal dysfunction associated with infrarenal aortic cross-clamping. J Cardioth Vasc Anesth. 1992;6:295-298.

Seeman-Lodding H, Biber B, Martner J. Cardiovascular responses to experimental infra-renal aortic cross-clamping: Modulating effects of isoflurane, sodium nitroprussiate and milrinone. Acta Anaesthesiol Scand. 1996;40:408-415.

Sundeman H, Biber B, Heniksson BA. Effects of desflurane on systemic, preportal and renal circulatory responses to infra-renal aortic cross-clamping in the pig. Acta Anaesthesiol Scand. 1996;40:876-882.

Kazama T, Ikeda K. Comparison of MAC and the rate of rise of alveolar concentration of sevoflurane with halothane and isoflurane in the dog. Anesthesiology. 1988;68:435-437.

Morrison DF. Multivariate Statistical Methods. 1967:338.

Roisen MF, Beaupre PN, Alpert RA. Monitoring with two-dimensional transesophageal echocardiography: Comparison of myocardial function in patients undergoing supra-celiac, suprarenal-infraceliac, or infrarenal aortic occlusion. J Vasc Surg. 1984;1:300-305.

Harpole DH, Clements FM, Quill T. Right and left ventricular performance during and after abdominal aortic aneurysm repair. Ann Surg. 1989;209:356-362.

Kien ND, White DA, Reitan JA. The influence of adenosine triphosphate on left ventricular function and blood flow distribution during aortic crossclamping in dogs. J Cardiothor Vasc Anesth. 1987;1:114-122.

Quintin L, Bonnet F, Macquin I. Aortic surgery: effect of clonidine on intra-operative catecholaminergic and circulatory stability. Acta Anaesthesiol Scand. 1990;34:132-137.

Vandermeer TJ, Maini BS, Hendershott TH. Evaluation of right ventricular function during aortic operations. Arch Surg. 1993;128:582-585.

Eger II EI. New inhaled anesthetics. Anesthesiology. 1994;80:906-922.

Heerdt PM, Pleimann BE. The dose-dependent effects of halothane on right ventricular contraction pattern and regional inotropy in swine. Anesth Analg. 1996;82:1152-1158.

Heerdt PM, Gandhi CD, Dickstein ML. Disparity of isoflurane effects on left and right ventricular after load and hydraulic power generation in swine. Anesth Analg. 1998;87:511-521.

Malan TP, Dinardo JA, Isner RJ et al. Cardiovascular effects of sevoflurane compared with those of isoflurane in volunteers. Anesthesiology. 1995;83:918-928.

Rooke AG, Ebert T, Muzi M. The hemodynamic and renal effects of sevoflurane and isoflurane in patients with coronary artery disease and chronic hypertension. Anesth Analg. 1996;82:1159-1165.

Mutoh T, Nishimura R, Kim HY. Cardiopulmonary effects of sevoflurane, compared with halothane, enflurane, and isoflurane in dogs. Am J Vet Res. 1997;58:885-890.

Colson P, Ribsteien J, Séguin JR. Mechanism of renal hemodynamic impairment during infrarenal aortic cross-clamping. Anesth Analg. 1992;75:18-23.

Nielsen VG. Xanthyne oxidoreductase release after descending thoracic aorta occlusion and reperfusion in rabbits. J Thorac Cardiovasc Surg. 1994;107:1222-1227.

Reiz S, Peter T, Rais O. Hemodynamic effects of infra-renal and common iliac artery desclamping in man. An approach to optimal volume loading. Acta Anaesthesiol Scand. 1979;23:579-586.

Colson P, Capdevilla X, Cuchet D. Does choice of the anesthetic influence renal function during infrarenal aortic surgery?. Anesth Analg. 1992;74:481-485.

Reis JMV, Braz JRC, Pereira SM. Comportamento hemodinâmico de pacientes portadores de aneurisma da aorta abdominal e de síndrome de Leriche durante enxerto aorto bifemoral. Rev Bras Anestesiol. 1994;44:(Supl18):CBA155.

Massone F. Anestesiologia Veterinária. 1999:225.

5ddd31ea0e882568771da3e9 rba Articles
Links & Downloads

Braz J Anesthesiol

Share this page
Page Sections