期刊
BRITISH JOURNAL OF ANAESTHESIA
卷 87, 期 5, 页码 748-754出版社
ELSEVIER SCI LTD
DOI: 10.1093/bja/87.5.748
关键词
anaesthetic techniques, inhalation; parasympathetic nervous system, vagus; heart, cardiac output
Inhalation anaesthetics decrease heart rate in isolated hearts but mostly increase heart rate in the intact organism, although most inhibit sympathetic drive. Differences in the degree of increase in heart rate between agents may be related to differences in their vagolytic action. To test this hypothesis, we studied the effects of halothane (H), isoflurane (I), enflurane (E), sevoflurane (S) and desflurane (D) [1-3 MAC (minimum alveolar concentration)] on heart rate and heart rate variability (HRV) as a measure of cardiac vagal activity in seven dogs. HRV was analysed in the time domain as the standard deviation of the RR interval (SDNN) and in the frequency domain as power in the high-frequency (HF, 0.15-0.5 Hz) and low-frequency (LF, 0.04-0.15 Hz) ranges. Heart rate increased with anaesthetic concentration and there were corresponding decreases in SDNN, HF power and LF power. Heart rate increased most with D (+40 beats min(-1)), least with H (+8 beats min(-1)) and to an intermediate extent with S, I and E. SDNN and HIP power, as measures of vagal activity, changed in the opposite direction and decreased in the same order as heart rate increased. However, SDNN and HF power correlated significantly with heart rate [r= -0.81 (0.04) and -0.81 (0.03) respectively] and were independent of the anaesthetic and its concentration (P<0.05). Consistent with our hypothesis, these results suggest that differences between agents in the degree of increase in heart rate are explained by differences in their vagolytic action.
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