The influence of xenon on regulation of the autonomic nervous system in patients at high risk of perioperative cardiac complications.
Br J Anaesth
; 96(4): 427-36, 2006 Apr.
Article
em En
| MEDLINE
| ID: mdl-16500952
ABSTRACT
BACKGROUND:
As xenon anaesthesia (XE) does not produce haemodynamic depression its use may be of benefit in patients at high risk of intraoperative haemodynamic instability and perioperative cardiac complications. XE (n=22) was compared with total i.v. anaesthesia (TIVA, n=22) for differences in autonomic regulation, peri- and postoperative performance.METHODS:
Patients undergoing abdominal aortic surgery were studied at five events T1 baseline awake; T2 anaesthesia induction; T3 before aortic cross-clamping; T4 after aortic cross-clamping; T5 after aortic declamping. T3-T5 end-tidal xenon concentration 60 (5)%. Intraoperativeanalysis:
heart rate, heart rate variability, blood pressure and cardiac output. Postoperativeanalysis:
24 h Holter ECG, intensive care unit and hospital stay, and patient's outcome after 6 months.RESULTS:
XE in contrast to TIVA increased parasympathetic and decreased sympathetic activity. Median low to high frequency decreased significantly in the XE group after start of XE (P<0.05) and remained significantly lower during all events after start of XE as compared with TIVA (P=0.0001). After start of XE heart rate of these patients was significantly lower as compared with TIVA (P=0.04). Cardiac output increased significantly in TIVA after aortic declamping (P<0.05). Outcome parameters did not differ significantly between groups.CONCLUSIONS:
XE patients demonstrated lower sympathetic and higher parasympathetic activity as compared with TIVA patients. This was reflected by significant differences in haemodynamics but did not correlate with a better postoperative outcome. Thus, it remains controversial whether XE provides benefits in high risk patients.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Aorta Abdominal
/
Sistema Nervoso Autônomo
/
Xenônio
/
Anestésicos Inalatórios
Tipo de estudo:
Clinical_trials
/
Etiology_studies
/
Risk_factors_studies
Limite:
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Br J Anaesth
Ano de publicação:
2006
Tipo de documento:
Article
País de afiliação:
Alemanha