[Cardiovascular effects of isoflurane-nitrous oxide anesthesia in peripheral and abdominal surgical interventions]

The cardiovascular actions of isoflurane-nitrous oxide anesthesia were studied in 20 patients (age rage 46-76 yr) undergoing laparatomy (group A = 13 patients) or peripheral vascular surgery (group B = 7 patients). Measurements were performed in the awake state, 20 min after induction of anesthesia and during surgical stimulation. Isoflurane produced small changes in heart rate but a significant reduction in mean arterial pressure which was due to a reduction in peripheral vascular resistance and myocardial contractility. During surgical stimulation arterial pressure rose above control values in group A but remained below control in group B. Cardiac index and stroke volume index both decreased after induction of anesthesia in group A and B. During surgical stimulation cardiac index increased in group A due to an increase in heart rate but remained below control in group B, while stroke volume index was reduced in both groups throughout the whole procedure. These results suggest, that contrary to the findings in human volunteers, isoflurane produces a significant cardiovascular depression in aged surgical patient.