Keyl Cornelius, Schneider Annette, Hobbhahn Jonny, Bernardi Luciano
Department of Anesthesiology, University of Regensburg, Germany.
Anesth Analg. 2002 Dec;95(6):1629-36, table of contents. doi: 10.1097/00000539-200212000-00029.
Sevoflurane and desflurane modulate autonomic nervous activity by different mechanisms. We tested the hypothesis that these anesthetics also exhibit different effects on short-term baroreflex regulation of arterial blood pressure. Forty ASA physical status I patients, aged 20 to 42 yr, were randomly assigned to receive either 1.0 minimum alveolar anesthetic concentration of sevoflurane or desflurane for the maintenance of anesthesia. Patients were studied during awake conditions and 20 min after the anesthesia induction using sinusoidal neck suction at 0.2 Hz (baroreflex response mediated mainly by vagal activity) and 0.1 Hz (baroreflex response mediated by vagal and sympathetic activity), whereas respiratory frequency was fixed at 0.25 Hz. RR interval and arterial blood pressure responses were evaluated by power spectral analysis and complex transfer function analysis. Sevoflurane and desflurane did not disturb the linear relationship between baroreceptor stimulation and effector response, expressed as squared coherence of signals, i.e., the equivalent of the correlation coefficient of power spectra. Sevoflurane and desflurane depressed the response of the heart rate to neck suction in a similar way without affecting the time delay between baroreceptor stimulation and vagal-mediated cardiac response. The gain of the transfer function between neck suction and oscillation in arterial blood pressure at 0.1 Hz decreased with sevoflurane and desflurane to comparable values. Both anesthetics increased the delay of systolic blood pressure response to baroreceptor stimulation from approximately 3.5 to 4.3 s. Baroreflex-mediated short-term control of arterial blood pressure is similar between desflurane and sevoflurane during steady-state conditions.
Despite exhibiting different effects on autonomic activity, sevoflurane and desflurane depress the baroreflex-mediated short-term control of heart rate and blood pressure in a similar manner.
七氟烷和地氟烷通过不同机制调节自主神经活动。我们检验了这样一个假设，即这些麻醉药对动脉血压的短期压力反射调节也表现出不同的影响。40例年龄在20至42岁之间的美国麻醉医师协会（ASA）身体状况I级患者，被随机分配接受1.0最低肺泡有效浓度的七氟烷或地氟烷用于维持麻醉。在清醒状态以及麻醉诱导后20分钟期间对患者进行研究，使用0.2赫兹的正弦颈部吸引（压力反射反应主要由迷走神经活动介导）和0.1赫兹（压力反射反应由迷走神经和交感神经活动介导），而呼吸频率固定在0.25赫兹。通过功率谱分析和复传递函数分析评估RR间期和动脉血压反应。七氟烷和地氟烷并未干扰压力感受器刺激与效应器反应之间的线性关系，以信号的平方相干性表示，即相当于功率谱的相关系数。七氟烷和地氟烷以相似的方式抑制心率对颈部吸引的反应，而不影响压力感受器刺激与迷走神经介导的心脏反应之间的时间延迟。在0.1赫兹时，颈部吸引与动脉血压振荡之间的传递函数增益在七氟烷和地氟烷作用下降低至相当的值。两种麻醉药均使收缩压对压力感受器刺激的反应延迟从约3.5秒增加至4.3秒。在稳态条件下，地氟烷和七氟烷之间压力反射介导的动脉血压短期控制相似。
尽管七氟烷和地氟烷对自主神经活动表现出不同影响，但它们以相似的方式抑制压力反射介导的心率和血压短期控制。
