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Cardiovascular Actions of Common Anesthetic Adjuvants During Desflurane (I-653) and Isoflurane Anesthesia in Swine

Departments of Anesthesia and Physiology, and the Cardiovascular Research Institute, University of California, San Francisco, California.

Abstract

To determine the cardiovascular actions of drugs commonly combined with inhalation anesthetics, we administered one drug from each of several classes of adjuvants to seven swine already anesthetized with equipotent concentrations (1.2 MAC) of desflurane, formerly 1–653, a new inhaled anesthetic, or isoflurane. Succinylcholine (1 and 2 µg/kg), atracurium (0.6 mg/kg), and atropine (5 µg/kg) plus edrophonium (5 mg/kg) had no cardiovascular effects. Fentanyl was given in amounts that decreased MAC for the inhaled anesthetics by 25%-35%. A dose of 50 µg/kg IV had no cardiovascular effects during either anesthetic, whereas 100 µg/kg IV modestly increased systemic vascular resistance without changing other variables. Naloxone (100 µg/kg IV) during infusion of fentanyl decreased systemic vascular resistance and increased cardiac output during both desflurane and isoflurane anesthesia, increased heart rate during only isoflurane anesthesia, and did not affect mean arterial blood pressure during either anesthetic. Thi-opental (2.5 and 5.0 mg/kg IV) decreased mean aortic blood pressure, cardiac output, stroke volume, and systemic vascular resistance during both anesthetics without altering heart rate or left- or right-sided cardiac filling pressures. The addition of 60% nitrous oxide caused no cardiovascular changes during desflurane anesthesia, but increased systemic vascular resistance and decreased cardiac output and stroke volume during isoflurane without altering heart rate or cardiac preload. We conclude that the usual clinical doses of adjuvants commonly administered during anesthesia have no untoward cardiovascular actions during 1.2 MAC desflurane or isoflurane anesthesia in swine.

Key Words: ANESTHETICS, VOLATILE-desflurane, isoflurane • ANALGESICS, FENTANYL • NEUROMUSCULAR RELAXANTS, ATRACURIUM, SUCCINYLCHOLINE • ANESTHETICS, GASES-nitrous oxide • ANTAGONISTS, NEUROMUSCULAR-edrophonium • PARASYMPATHETIC NERVOUS SYSTEM, ATROPINE