Propofol, but not etomidate, reduces desflurane-mediated sympathetic activation in humans. Can J Anaesth 1999 Apr;46(4):342-7
Date
05/08/1999Pubmed ID
10232717DOI
10.1007/BF03013225Scopus ID
2-s2.0-0033022090 (requires institutional sign-in at Scopus site) 14 CitationsAbstract
PURPOSE: The administration of desflurane to humans can lead to substantial activation of the neurohumoral axis. Propofol can inhibit the sympathetic response to stress. This study compared the neurocirculatory effects of induction of anesthesia with propofol with those of etomidate on desflurane-mediated sympathetic activation.
METHODS: After informed consent, awake baseline recordings of heart rate (HR), mean arterial blood pressure (MAP), and efferent sympathetic nerve activity (SNA, peroneal nerve) were obtained from healthy volunteers randomly assigned to receive either 2.5 mg x kg(-1) propofol (n=8) or 0.3 mg x kg(-1) etomidate (n=7). Two minutes after i.v. induction, desflurane 3.6% was added to the inspired gas, and increased in consecutive minutes to 7% and 10.9%. Ventilation via mask was continued for an additional seven minutes. Normocarbia was maintained while neurocirculatory parameters were continuously recorded.
RESULTS: There were no differences between groups at baseline. The administration of desflurane via mask after etomidate led to increases in HR, MAP and SNA. Propofol significantly reduced the MAP response and delayed and attenuated the sympatho-excitation.
CONCLUSION: Propofol induction reduced the sympathetic activation and hypertension associated with desflurane.
Author List
Lopatka CW, Muzi M, Ebert TJAuthor
Thomas J. Ebert MD, PhD Adjunct Professor in the Anesthesiology department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdultAnalysis of Variance
Anesthetics, Inhalation
Anesthetics, Intravenous
Blood Pressure
Drug Interactions
Efferent Pathways
Etomidate
Heart Rate
Humans
Hypertension
Isoflurane
Male
Motor Neurons
Neurotransmitter Agents
Peroneal Nerve
Propofol
Stress, Physiological
Sympathetic Nervous System
