Sympathetic activation with desflurane in humans. 1994

T J Ebert, and M Muzi
Department of Anesthesiology, Veterans Affairs Medical Center, Milwaukee, Wisconsin.

Although the blood pressure lowering effects of desflurane and isoflurane were similar at equi-MAC, we noted a different pattern of response during intervals of rapidly increasing the inspired concentration of desflurane, when substantial increases in SNA, HR, and MAP occurred. Because of the lower potency of desflurane compared to isoflurane, higher concentrations of desflurane are necessary to establish an adequate surgical plane of anesthesia. Although clinically relevant concentrations of isoflurane did not trigger sympathetic activation, isoflurane triggered responses at an inspired concentration (approximately 5%) nearly equal to that of desflurane. The present research demonstrates that the initial exposure to desflurane in clinically relevant concentrations following anesthetic induction and the deepening of anesthesia with higher concentrations of desflurane can be profoundly sympatho-excitatory. Considerable caution should be taken when administering desflurane to patients who may be placed at risk by these responses.

UI MeSH Term Description Entries
D007530 Isoflurane A stable, non-explosive inhalation anesthetic, relatively free from significant side effects.
D008297 Male Males
D001794 Blood Pressure PRESSURE of the BLOOD on the ARTERIES and other BLOOD VESSELS. Systolic Pressure,Diastolic Pressure,Pulse Pressure,Pressure, Blood,Pressure, Diastolic,Pressure, Pulse,Pressure, Systolic,Pressures, Systolic
D006339 Heart Rate The number of times the HEART VENTRICLES contract per unit of time, usually per minute. Cardiac Rate,Chronotropism, Cardiac,Heart Rate Control,Heartbeat,Pulse Rate,Cardiac Chronotropy,Cardiac Chronotropism,Cardiac Rates,Chronotropy, Cardiac,Control, Heart Rate,Heart Rates,Heartbeats,Pulse Rates,Rate Control, Heart,Rate, Cardiac,Rate, Heart,Rate, Pulse
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000077335 Desflurane A fluorinated ether that is used as a volatile anesthetic for maintenance of general anesthesia. 1,2,2,2-Tetrafluoroethyl difluoromethyl ether,I 653,I-653,I653,Suprane
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D000777 Anesthetics Agents capable of inducing a total or partial loss of sensation, especially tactile sensation and pain. They may act to induce general ANESTHESIA, in which an unconscious state is achieved, or may act locally to induce numbness or lack of sensation at a targeted site. Anesthetic,Anesthetic Agents,Anesthetic Drugs,Anesthetic Effect,Anesthetic Effects,Agents, Anesthetic,Drugs, Anesthetic,Effect, Anesthetic,Effects, Anesthetic
D013564 Sympathetic Nervous System The thoracolumbar division of the autonomic nervous system. Sympathetic preganglionic fibers originate in neurons of the intermediolateral column of the spinal cord and project to the paravertebral and prevertebral ganglia, which in turn project to target organs. The sympathetic nervous system mediates the body's response to stressful situations, i.e., the fight or flight reactions. It often acts reciprocally to the parasympathetic system. Nervous System, Sympathetic,Nervous Systems, Sympathetic,Sympathetic Nervous Systems,System, Sympathetic Nervous,Systems, Sympathetic Nervous

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