Anesthesiology
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Echocardiographic studies were made of 20 healthy patients scheduled for minor surgical procedures to determine whether this technique could be used routinely in the operating room and to evaluate the effects of halothane and enflurane on left ventricular performance. Thirteen minutes following induction of anesthesia with halothane in ten patients (mean end-tidal halothane concentration 0.93 per cent), mean arterial blood pressure, left ventricular (LV) diastolic dimension, LV fractional shortening, mean velocity of circumferential fiber shortening and systolic thickening of the posterior LV wall were significantly decreased. ⋯ Twelve minutes following induction of anesthesia with enflurane in ten patients (mean delivered enflurane concentration 2.4 per cent), mean arterial blood pressure and LV systolic and diastolic dimensions were decreased, while heart rate was increased significantly, indicating that enflurane caused vasodilatation and may have had some depressant effect on contractility. Echocardiography is a non-invasive, safe and relatively rapid method that can be used in the perioperative period to assess cardiac function and to evaluate the effects of pharmacologic agents on the heart.
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Glutathione depletion following inhalation of halogenated anesthetics was investigated as a possible mechanism of toxic reactions associated with anesthesia. Concentrations of reduced glutathione were measured in the blood, liver, lung and kidney of the mouse after anesthesia with enflurane, fluroxene, halothane, isoflurane, methoxyflurane, or trichloroethylene. The anesthetic had no effect on glutathione concentrations in tissues except when fluroxene was used. ⋯ Glutathione was also depleted in livers and lungs of rats anesthetized with fluroxene (60 and 38 per cent, respectively). In blood of rhesus monkeys anesthetized with fluroxene, glutathione was depleted by only 13 per cent. Extents of glutathione depletion are related to fluroxene toxicities in the three species studied.