Journal of anesthesia
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Journal of anesthesia · Jun 1997
Circulatory and catecholamine responses to tracheal intubation and skin incision during sevoflurane, isoflurane, or halothane anesthesia.
The anesthetic suppression of responses to noxious stimuli might reflect a summation of the suppression of the basal functions and the response capability. We investigated the basal suppression and response capability in hemodynamics and plasma catecholamine levels with different anesthetics at the same minimum alveolar concentration (MAC) level. Fifty-four patients were allocated to one of 6 groups to receive sevoflurane, isoflurane, or halothane at 1.25 or 2.0 MAC. ⋯ The mean arterial pressure, heart rate, rate-pressure product, and plasma levels of noradrenaline and adrenaline at the prestimuli period showed no difference between agents at each MAC. The rises in these variables by tracheal intubation and skin incision were greatest in the sevoflurane group, least in the halothane group, and intermediate in the isoflurane group. Although basal hemodynamic suppression is similar at the same MAC, the suppressive action of sevoflurane on the circulatory response capability to noxious stimuli is weaker than that of isoflurane and halothane.
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Journal of anesthesia · Jun 1997
Effects ofL-arginine andN-nitro-L-arginine treatment on hemodynamics, DO2, VO 2, and extravascular lung water in a dog endotoxin shock model.
To verify the effect of nitric oxide pathway modification during sepsis, experiments were conducted in four groups of anesthetized dogs which received lipopolysaccharide (LPS) intravenously (group 1), 300 mg·kg(-1) ofL-arginine plus LPS (group 2), 20 mg·kg(-1) ofN-nitro-L-arginine plus LPS (L-NNA, group 3), and normal saline as the control group. Hemodynamic and oxygenation data as well as extravascular lung water (EVLW) were measured or calculated. The results showed thatL-arginine increases cardiac output index (CI) and decreased the peripheral vascular resistance index (PVRI) without a significant influence on oxygen extraction ratio (O2ER), oxygen delivery (DO2), or oxygen consumption (VO2). ⋯ Therefore, as DO2 was significantlys decreased byL-NNA, and although O2ER was increased (insufficiently), VO2 was still decreased significantly. EVLW was markedly increased byL-NNA. These results support the hypothesis that inhibition of nitric oxide synthesis may exacerbate hemodynamic and oxygenation consequences in septic shock.