[Comparative echocardiographic studies on the negative inotropic effect of halothane, enflurane and isoflurane]

Using the afterload-independent end-systolic pressure-dimension-relationship a study was performed in order to investigate whether there are differences in the negative inotropic effects of halothane, enflurane and isoflurane at 1 MAC in 70% N2O. 30 patients of ASA-groups I and II were studied. Using transoesophageal 2d- and m-mode echocardiography the end-systolic-pressure-dimension-relationship was established and the slope (parameter of contractility) determined. The slope decreased significantly (paired Wilcoxon-test 2 alpha less than 0.01) with halothane (68.5/46.5 mmHg/cm), enflurane (56/48 mm Hg/cm) and isoflurane (63/35 mmHg/cm). There is no difference between the three groups (Kruskal-Wallis-test 2 alpha greater than 0.05). The negative inotropic effects of halothane, enflurane and isoflurane at 1 MAC in 70% N2O are the same. The vasodilation caused by isoflurane enables better pump function compared to halothane and enflurane, but may cause severe hypotension. We conclude that for cardiac risk patients isoflurane has no outstanding advantages in comparison to halothane and enflurane.