Myocardial metabolism and hemodynamic responses with isoflurane anesthesia for coronary arterial surgery.

Abstract:

:Isoflurane-oxygen was given for induction and maintenance of anesthesia to ten patients having coronary artery bypass grafts. All had preserved ventricular function without hypertension or other cardiac lesions; treatment with beta-blocking drugs was maintained until the operation in all patients. Cardiac output, arterial and central pressures, coronary sinus (CS) blood flow, arterial and CS oxygen, Hb, and lactate contents were measured before, six times during, and twice after anesthesia. On induction, systolic arterial pressure was purposely reduced 33% along with systemic resistance by increasing the concentration of isoflurane; cardiac index, heart rate, and coronary flow did not change. Coronary resistance decreased 23% and CS oxygen content increased 56%; but in three of ten patients myocardial lactate production took place, evidence of global ischemia. Induction of anesthesia was not smooth in three patients. Controlled hemodynamic depression could be maintained with isoflurane-oxygen, but the frequency of myocardial lactate production before and after perfusion was greater than with other general anesthetics. Isoflurane dilated portions of the coronary bed but, because anaerobic metabolism occurred concomitantly, the theory that redistribution of flow can take place resulting in ischemic areas of ventricle is supported.

journal_name

Anesth Analg

journal_title

Anesthesia and analgesia

authors

Moffitt EA,Barker RA,Glenn JJ,Imrie DD,DelCampo C,Landymore RW,Kinley CE,Murphy DA

subject

Has Abstract

pub_date

1986-01-01 00:00:00

pages

53-61

issue

1

eissn

0003-2999

issn

1526-7598

journal_volume

65

pub_type

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