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ANESTHETIC PHARMACOLOGY

Sinusoidal Neck Suction for Evaluation of Baroreflex Sensitivity During Desflurane and Sevoflurane Anesthesia

Cornelius Keyl, MD^*, Annette Schneider, MD^*, Jonny Hobbhahn, MD^*, and Luciano Bernardi, MD

*Department of Anesthesiology, University of Regensburg, Germany; Department of Internal Medicine, University of Pavia, and Istituto di Ricovero e Cura a Carattere Scientifico S. Matteo, Pavia, Italy

Address correspondence and reprint requests to Cornelius Keyl, MD, Department of Anesthesiology, University of Regensburg, Franz-Josef-Strauß-Allee 11, 93042 Regensburg, Germany. Address e-mail to cornelius.keyl{at}klinik.uni-regensburg.de

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.

IMPLICATIONS: 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.

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