Isoflurane potency and cardiovascular effects during short exposures in the foetal lamb

Isoflurane is a relatively new volatile anaesthetic in clinical practice and increasing use for obstetrical patients might be expected. A previous study demonstrated that a 60-90 minute exposure of the foetus to isoflurane resulted in a significant fall in foetal cardiac output with development of foetal acidosis. To determine the cardiovascular effects of a shorter exposure of the foetal lamb to isoflurane and the potency (MAC) of isoflurane in the foetus, the following study was done. Eleven pregnant ewes were surgically prepared by placing indwelling arterial and venous catheters into the mother and foetus. After a 48-hour recovery period, isoflurane, two per cent in oxygen, was administered to six ewes via a tracheostomy for 30 minutes. Foetal cardiac outputs and regional blood flows were measured by the microsphere method. In five ewes the concentration of isoflurane was varied and MAC determinations were done on both ewe and foetus. Arterial blood levels of isoflurane were used to determine foetal MAC. Exposure to isoflurane resulted in a significant decrease in maternal and foetal mean arterial blood pressures and in foetal heart rate. Exposures up to 30 minutes did not result in foetal acidosis or a significant fall in cardiac output. Maternal and foetal MAC for isoflurane were determined to be 0.86 and 0.34 per cent respectively.