Key result
Isoflurane depressed baroreflex slope and heart rate range in both brain-intact and decerebrate rats, indicating its actions do not require suprapontine central nervous system sites.
Isoflurane depresses heart rate baroreflex control primarily via the sympathetic nervous system, independent of suprapontine central nervous system sites.
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Should not alter anesthetic choice in humans; leaves open translation of brainstem-level baroreflex effects to clinical settings.
BACKGROUND: Isoflurane inhibits baroreflex control of heart rate (HR) by poorly understood mechanisms. The authors examined whether suprapontine central nervous system cardiovascular regulatory sites are required for anesthetic depression. METHODS: The effects of isoflurane (1 and 2 rat minimum alveolar concentration [MAC]) on the baroreflex control of HR were determined in sham intact and midcollicular-transected decerebrate rats. Intravenous phenylephrine (0.2-12 microg/kg) and nitroprusside (1-60 microg/kg) were used to measure HR responses to peak changes in mean arterial pressure (MAP). Sigmoidal logistic curve fits to HR-MAP data assessed baroreflex sensitivity (HR/MAP), HR range, lower and upper HR plateau, and MAP at half the HR range (BP50). Four groups (two brain intact and two decerebrate) were studied before, during, and after isoflurane. To assess sympathetic and vagal contributions to HR baroreflex, beta-adrenoceptor (1 mg/kg atenolol) or muscarinic (0.5 mg/kg methyl atropine) antagonists were administered systemically. RESULTS: Decerebration did not alter resting MAP and HR or baroreflex parameters. Isoflurane depressed baroreflex slope and HR range in brain-intact and decerebrate rats. In both groups, 1 MAC reduced HR range by depressing peak reflex tachycardia. Maximal reflex bradycardia during increases in blood pressure was relatively preserved. Atenolol during 1 MAC did not alter maximum reflex tachycardia. In contrast, atropine during 1 MAC fully blocked reflex bradycardia. Therefore, 1 MAC predominantly depresses sympathetic components of HR baroreflex. Isoflurane at 2 MAC depressed both HR plateaus and decreased BP50 in both groups. CONCLUSIONS: Isoflurane depresses HR baroreflex control by actions that do not require suprapontine central nervous system sites. Isoflurane actions seem to inhibit HR baroreflex primarily by the sympathetic nervous system.
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Lee et al. (2002) studied Baroreflex control of heart rate. Isoflurane vs. Before and after isoflurane was evaluated on Baroreflex sensitivity (HR/MAP), HR range, lower and upper HR plateau, and BP50. Isoflurane depressed baroreflex slope and heart rate range in both brain-intact and decerebrate rats, indicating its actions do not require suprapontine central nervous system sites.
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