What question did this study set out to answer?

To compare heart rate, blood pressure, and autonomic nervous system responses between desflurane/N2O and isoflurane/N2O anaesthesia in patients prior to vascular surgery.

October 1, 1998Acta Anaesthesiologica Scandinavica

Comparison of the haemodynamic actions of desflurane/N2O and isoflurane/N2O anaesthesia in vascular surgical patients

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Why the study?

Does desflurane/N2O compared to isoflurane/N2O alter heart rate, arterial blood pressure, and sympathetic activity in elderly vascular surgical patients?

Population

n=25 elderly patients before vascular surgery, whose trachea had been intubated after propofol induction

Comparison

Desflurane at 1 and 1.5 MAC in N2O (60%) vs Isoflurane at 1 and 1.5 MAC in N2O (60%)

Design

RCT, random manner

Authors

AZA. ZubickiSorbonne Université XGX. GostinSorbonne Université DMD. MicleaSorbonne Université

Discussion

Member takes

Implication

Both anesthetics similarly lower BP without sympathetic activation in elderly vascular patients; challenges prior volunteer reports of desflurane-induced hyperactivity.

Key Points

To compare heart rate, blood pressure, and autonomic nervous system responses between desflurane/N2O and isoflurane/N2O anaesthesia in patients prior to vascular surgery.
Randomized clinical trial of 25 patients intubated following propofol induction prior to vascular surgery.
Patients received either desflurane or isoflurane at 1.0 and 1.5 minimum alveolar concentration (MAC) in 60% nitrous oxide (N2O) in a random sequence.
Autonomic nervous system changes were assessed using power spectral analysis (PSA) of heart rate and blood pressure alongside plasma catecholamine and plasma renin activity measurements.
At anaesthetic depth up to 1.5 MAC, arterial blood pressure and PSA-derived indices of sympathetic activity decreased under both desflurane and isoflurane.
Heart rate and plasma catecholamine concentrations did not change significantly with either agent, whereas plasma renin activity increased significantly at 1.5 MAC in both groups.

Structured PICO

Does desflurane/N2O compared to isoflurane/N2O alter heart rate, arterial blood pressure, and sympathetic activity in elderly vascular surgical patients?

Population

n=25 elderly patients before vascular surgery, whose trachea had been intubated after propofol induction

Intervention

Desflurane at 1 and 1.5 MAC in N2O (60%)

Comparator

Isoflurane at 1 and 1.5 MAC in N2O (60%)

Outcome

Heart rate and arterial blood pressure response, and associated changes in the autonomic nervous system (evaluated using power spectral analysis of heart rate and blood pressure and measured plasma catecholamine concentrations)surrogate

Desflurane and isoflurane have similar blood pressure-lowering effects in elderly vascular surgical patients, without inducing the sympathetic hyperactivity previously observed in healthy volunteers.

Cite This Study

Zubicki et al. (1998) studied this question.

synapsesocial.com/papers/6a908ff6e16d749e8fc92b80 https://doi.org/10.1111/j.1399-6576.1998.tb05376.x

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Implication

Both anesthetics similarly lower BP without sympathetic activation in elderly vascular patients; challenges prior volunteer reports of desflurane-induced hyperactivity.

Comparison of the haemodynamic actions of desflurane/N2O and isoflurane/N2O anaesthesia in vascular surgical patients

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Comparison of the haemodynamic actions of desflurane/N2O and isoflurane/N2O anaesthesia in vascular surgical patients

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

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