Comparisons of vasodilators and anesthetics in their effects on the circulatory and metabolic conditions during hypotensive anesthesia
Toi, T.
Masui. Japanese Journal of Anesthesiology 49(8): 857-866
2000
ISSN/ISBN: 0021-4892 PMID: 10998877 Document Number: 521260
The effects of vasodilators and anesthetics on the circulatory and metabolic conditions were compared during hypotensive anesthesia. Forty two subjects undergoing tympanoplasty were divided into 6 groups: PG + S: N2O/sevoflurane with prostaglandinE1 (PG), TM + S: N2O/sevoflurane with trimetaphan (TM), NG + S: N2O/sevoflurane with trinitoglycerin (NG), PG + P: N2O/propofol with PGE1, TM + P: N2O/propofol with TM, NG + P: N2O/propofol with NG. There were marked changes in pulse rate, PaO2, L/P ratio and gastric intramural pH (pHi) in groups PG + S, TM + S and NG + S in which sevoflurane was used compared with groups PG + P, TM + P and NG + P in which propofol was used. Dosages of TM in (TM + P) group were 3 times greater compared with TM + S group B, while, there was no difference in the dosages of PG and TN, under propofol or sevoflurane anesthesia. Although pHi decreased slightly during hypotensive anesthesia in all groups, pHi was not decreased below the critical level of 7.30. The circulatory and metabolic conditions under induced hypotensive anesthesia were influenced by both vasodilators and anesthetics, and the dosage of vasodilator to decrease arterial blood pressure was dependent on the anesthetic used simultaneously.