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Canadian Journal of Anesthesia, Vol 14, 442-469, Copyright © 1967 by Canadian Anesthesiologists' Society

The Neuroendocrine and Metabolic Effects of General Anaesthesia Associated with Acute Hypoxia and Acute Hypercapnia

ALLEN B. DOBKIN M.D., PETER H. BYLES M.B., BENJAMIN F. AFRICA M.D., and JOHN F. NEVILLE JR. M.D.

Serial crossover experiments were performed on large trained male dogs who were moderately deeply anaesthetized for 90 minutes at two to three weekly intervals with thiopental, Innovar, diethyl ether, chloroform, trichlorethylene, fluroxene, halothane, halothane-ether azeotrope, and methoxyflurane. In one series, they were rendered hypoxic by mechanical ventilation with a 10 per cent oxygen mixture and, in the other, respiratory acidosis was induced by the addition of 7.5 per cent CO2 to the gas mixture. Blood assays of histamine, serotonin, epinephrine, and nor-epinephrine were performed at the beginning and end of each experiment, together with estimations of blood pH, Pacoco2, Paoo2, Saoo2, haematocrit, blood water, lactate, pyruvate, blood sugar, serum potassium, and serum inorganic phosphorus. Mean arterial blood pressure, heart rate, E.C.G., pulmonary ventilation, and urine output were monitored throughout. Statistical analysis of the results led to the following conclusions:

1. The changes in neuroendocrine substances were quite variable and no clearcut pattern emerged. Changes in the catecholamine levels did not correlate with changes in the other variables measured.

2. The blood sugar was uniformly raised, particularly in the hypercapnic animals.

3. Serum potassium was uniformly depressed.

4. Serum inorganic phosphorus rose with hypercapnia but fell with hypoxia.

5. Whole blood lactate, pyruvate, excess lactate, and L/P ratio tended to rise, more in the hypoxic dogs and maximally with diethyl ether.

6. Hypercapnia tended to produce hypotension and bradycardia except with diethyl ether, while hypoxaemia led to variable effects on the blood pressure and an over-all tachycardia except with Innovar and halothane.

Note:

From the Anesthesiology and Cardiovascular Surgery Laboratories, State University of New York, Upstate Medical Center, Syracuse, New York. This project was supported by grants-in-aid from Abbott Laboratories, Ayerst Laboratories, McNeil Laboratories, E. R. Squibb & Son and USPHS Grant 05402-04,5.






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Copyright © 1967 by the Canadian Anesthesiologists' Society.