Jl. Hanouz et al., In vitro effects of desflurane, sevoflurane, isoflurane, and halothane in isolated human right atria, ANESTHESIOL, 92(1), 2000, pp. 116-124
Citations number
37
Categorie Soggetti
Aneshtesia & Intensive Care","Medical Research Diagnosis & Treatment
Background: Direct myocardial effects of volatile anesthetics have been stu
died in various animal species in vitro. This study evaluated the effects o
f equianesthetic concentrations of desflurane, sevoflurane, isoflurane, and
halothane on contractile parameters of isolated human atria in vitro.
Methods: Human right atrial trabeculae, obtained from patients undergoing c
oronary bypass surgery, were studied in an oxygenated (95% O-2-5% CO2) Tyro
de's modified solution ([Ca2+](o) = 2.0 mM, 30 degrees C, stimulation frequ
ency 0.5 Hz). The effects of equianesthetic concentrations (0.5, 1, 1.5, 2,
and 2.5 minimum alveolar concentration [MAC]) of desflurane, sevoflurane,
isoflurane, and halothane on inotropic and lusitropic parameters of isometr
ic twitches were measured.
Results: Isoflurane, sevoflurane, and desflurane induced a moderate concent
ration-dependent decrease in active isometric force, which was significantl
y lower than that induced by halothane. In the presence of adrenoceptor blo
ckade, the desflurane-induced decrease in peak of the positive force deriva
tive and time to peak force became comparable to those induced by isofluran
e. Halothane induced a concentration-dependent decrease in time to half-rel
axation and a contraction-relaxation coupling parameter significantly great
er than those induced by isoflurane, sevoflurane and desflurane.
Conclusions: in isolated human atrial myocardium, desflurane, sevoflurane,
and isoflurane induced a moderate concentration-dependent negative inotropi
c effect. The effect of desflurane on time to peak force and peak of the po
sitive force derivative could be related to intramyocardial catecholamine r
elease. At clinically relevant concentrations, desflurane, sevoflurane, and
isoflurane did not modify isometric relaxation.