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Propofol and autonomic reflex function in humans

T J Ebert1, M Muzi

  • 1Department of Anesthesiology, Medical College of Wisconsin, Milwaukee.

Anesthesia and Analgesia
|February 1, 1994
PubMed
Summary
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Propofol anesthesia significantly reduces baroreceptor reflex control of heart rate and sympathetic nerve activity. However, hypercarbia and nitrous oxide can partially restore these vital reflex functions.

Area of Science:

  • Anesthesiology
  • Cardiovascular Physiology
  • Autonomic Nervous System

Background:

  • Baroreceptor reflex is crucial for maintaining blood pressure and heart rate.
  • Propofol is a common anesthetic agent with known effects on cardiovascular function.

Purpose of the Study:

  • To evaluate the impact of propofol on baroreceptor reflex regulation of cardiac rate and sympathetic nerve activity.
  • To investigate the influence of normocarbia, hypercarbia, and nitrous oxide on these reflex responses during propofol anesthesia.

Main Methods:

  • Healthy male volunteers underwent infusions of propofol at varying rates.
  • Baroreceptor perturbations were induced using nitroprusside and phenylephrine.
  • Continuous monitoring of heart rate, blood pressure, and sympathetic nerve activity was performed.

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Main Results:

  • Propofol significantly reduced sympathetic nerve activity, blood pressure, and cardiac baroreceptor sensitivity.
  • Reflex sympathetic responses were abolished under normocarbic propofol anesthesia but improved with hypercarbia and nitrous oxide.
  • Reflex sensitivity to phenylephrine remained unchanged across conditions.

Conclusions:

  • Propofol markedly attenuates baroreceptor reflex responses to hypotension.
  • Hypercarbic conditions and co-administration with nitrous oxide can preserve reflex sympathetic function during propofol anesthesia.
  • Lower propofol doses with nitrous oxide may better maintain autonomic regulation.