Background: There is limited knowledge of the effects of anaesthetics on left ventricular (LV) diastolic function in humans. Our aim was to evaluate these effects in humans free from cardiovascular disease.
Methods: Sixty patients (aged 18-47 yr) who had no history or signs of cardiovascular disease were randomized to receive general anaesthesia with halothane, sevoflurane or propofol. Echocardiography was performed at baseline and during spontaneous respiration at 1 minimum alveolar concentration (MAC) of the inhalational agents or propofol 4 microg ml(-1) (step 1), and repeated during positive-pressure ventilation with 1 and 1.5 MAC of the inhalational agents or with propofol 4 and 6 microg ml(-1) (steps 2a and 2b). Analysis of echocardiographic measurements focused on heart rate corrected isovolumic relaxation time (IVRT(c)) and early diastolic peak velocity of the lateral mitral annulus (E(a)).
Results: IVRT(c) decreased from baseline to step 1 in the halothane group (82 [95% CI, 76-88] ms and 74 [95% CI, 68-80] ms respectively; P=0.02), remained stable in the sevoflurane group (78 [95% CI, 72-83] ms and 73 [95% CI, 67-81] ms; n.s.) and increased in the propofol group (80 [95% CI, 74-86] ms and 92 [95% CI, 84-102] ms; P=0.02). E(a) decreased in the propofol group only (18.8 [95% CI, 16.5-19.9] cm s(-1) and 16.0 [95% CI, 14.9-17.9] cm s(-1); P=0.003). From step 2a to step 2b, IVRT(c) increased further in the propofol group (109 [95% CI, 99-121] ms and 119 [95% CI, 99-135] ms; P=0.04) but remained stable in the other two groups. E(a) did not change from step 2a to step 2b.
Conclusions: Halothane and sevoflurane did not impair LV relaxation, whereas propofol caused a mild impairment. However, the impairment by propofol was of a magnitude that is unlikely to cause clinical diastolic dysfunction.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1093/bja/aei028 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Exploring the mechanisms by which common inhalational anesthetics influence malignant tumor metastasis: A data mining study based on comparative toxicogenomic databases.
Ecotoxicol Environ Saf
January 2025
Department of Anesthesiology, Fudan University Shanghai Cancer Center, Shanghai 200032, China. Electronic address:
Surgery remains the primary treatment for solid malignant tumors, but controlling postoperative tumor recurrence and metastasis continues to be a major challenge. Understanding the factors that influence tumor recurrence and metastasis after surgery, as well as the underlying biological mechanisms, is critical. Previous studies suggest that anesthetic agents may increase the risk of tumor recurrence and metastasis in patients with cancer, but the mechanisms underlying these findings remain unclear.
View Article and Find Full Text PDFHow to Personalize General Anesthesia-A Prospective Theoretical Approach to Conformational Changes of Halogenated Anesthetics in Fire Smoke Poisoning.
Int J Mol Sci
April 2024
Research Methodology Department, Faculty of Pharmacy, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania.
Smoke intoxication is a central event in mass burn incidents, and toxic smoke acts at different levels of the body, blocking breathing and oxygenation. The majority of these patients require early induction of anesthesia to preserve vital functions. We studied the influence of hemoglobin (HMG) and myoglobin (MGB) blockade by hydrochloric acid (HCl) in an interaction model with gaseous anesthetics using molecular docking techniques.
View Article and Find Full Text PDFAdvances in pediatric anesthesia services over the past 10 years in French-speaking sub-Saharan Africa.
Paediatr Anaesth
September 2024
Mother-and-children hospital Bingerville, Abidjan, Ivory Coast.
Introduction: To improve and maintain quality and safety in anesthesia, standards have been proposed regarding human resources, facilities and equipment, medications and intravenous fluids, monitoring, and the conduct of anesthesia. Compliance with these standards remains a challenge in French-speaking sub-Saharan Africa (SSA) and results in high morbidity and mortality particularly in children. This aim of this study was to assess the progress made in improving the pediatric anesthesia infrastructures, human resources, education, medications, and equipment in French-speaking SSA over the past 10 years (2013-2022).
View Article and Find Full Text PDFAn In Silico Investigation of the Molecular Interactions between Volatile Anesthetics and Actin.
Pharmaceuticals (Basel)
December 2023
DIMEAS, Politecnico di Torino, 10129 Turin, Italy.
Volatile anesthetics (VAs) are medicinal chemistry compounds commonly used to enable surgical procedures for patients who undergo painful treatments and can be partially or fully sedated, remaining in an unconscious state during the operation. The specific molecular mechanism of anesthesia is still an open issue, but scientific evidence supports the hypothesis of the involvement of both putative hydrophobic cavities in membrane receptors as binding pockets and interactions between anesthetics and cytoplasmic proteins. Previous studies demonstrated the binding of VAs to tubulin.
View Article and Find Full Text PDFThe halothane era in pediatric anesthesia: The convergence of a cardiac depressant anesthetic with the immature myocardium of infancy.
Paediatr Anaesth
July 2024
Department of Anesthesiology, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, Colorado, USA.
Article Synopsis
- Halothane was the primary inhalational anesthetic for children from the late 1950s until the late 1990s, but it posed significant risks, particularly for neonates and infants, due to its negative effects on heart function.
- In neonates, halothane caused increased rates of hypotension and cardiac arrest because their hearts are still developing and are more sensitive to the drug compared to older children.
- By the late 1990s, newer anesthetics like sevoflurane, which had a safer profile for pediatric patients, led to halothane's decline and eventual removal from pediatric anesthesia in North America.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!