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Related Experiment Videos

Sympathetic activation with desflurane in humans

T J Ebert1, M Muzi

  • 1Department of Anesthesiology, Veterans Affairs Medical Center, Milwaukee, Wisconsin.

Advances in Pharmacology (San Diego, Calif.)
|January 1, 1994
PubMed
Summary

Desflurane can cause significant increases in sympathetic activity, heart rate, and blood pressure, especially during anesthetic induction and deepening. Caution is advised when using desflurane in at-risk patients.

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Area of Science:

  • Anesthesiology
  • Cardiovascular Physiology
  • Autonomic Nervous System

Background:

  • Desflurane and isoflurane are volatile anesthetics with similar blood pressure-lowering effects at equipotent concentrations (MAC).
  • Higher concentrations of desflurane are required for anesthesia due to its lower potency compared to isoflurane.
  • Sympathetic activation patterns may differ between these agents during anesthetic management.

Purpose of the Study:

  • To compare the sympatho-excitatory effects of desflurane and isoflurane.
  • To investigate the impact of increasing inspired concentrations on autonomic responses.
  • To identify potential risks associated with desflurane administration.

Main Methods:

  • Comparison of desflurane and isoflurane at equi-MAC.
  • Monitoring of sympathetic nervous activity (SNA), heart rate (HR), and mean arterial pressure (MAP).
  • Assessment of responses during rapid increases in inspired anesthetic concentrations.

Main Results:

  • While equi-MAC effects were similar, desflurane caused significant increases in SNA, HR, and MAP during rapid concentration increases.
  • Clinically relevant concentrations of isoflurane did not trigger sympathetic activation.
  • Desflurane triggered sympathetic responses at concentrations around 5%, similar to isoflurane's threshold.

Conclusions:

  • Initial exposure and increasing concentrations of desflurane can be profoundly sympatho-excitatory.
  • Desflurane administration requires caution in patients susceptible to sympathetic activation.
  • Understanding these differential responses is crucial for safe anesthetic practice.

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