Pulmonary microvascular injury following general anaesthesia with volatile anaesthetics — halothane and isoflurane: a comparative clinical and experimental study

• Published in: Respiratory medicine 1997-07, Vol.91 (6), p.351-360
• Main Authors: Gunaydin, B., Karadenizli, Y., Babacan, A., Kaya, K., Unlu, M., Inanir, S., Mahli, A., Akcabay, M., Yardim, S.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Anesthesia, General - adverse effects; Anesthetics, Inhalation - adverse effects; Animals; Biological and medical sciences; Drug toxicity and drugs side effects treatment; Endothelium, Vascular - drug effects; Endothelium, Vascular - pathology; Female; Halothane - adverse effects; Humans; Isoflurane - adverse effects; Lung - diagnostic imaging; Lung - drug effects; Lung - metabolism; Male; Medical sciences; Metabolic Clearance Rate - drug effects; Microcirculation - drug effects; Middle Aged; Organotechnetium Compounds - pharmacokinetics; Oximes - pharmacokinetics; Pharmacology. Drug treatments; Postoperative Complications - chemically induced; Postoperative Complications - diagnostic imaging; Postoperative Complications - metabolism; Pulmonary Circulation - drug effects; Rabbits; Radionuclide Imaging; Technetium Tc 99m Exametazime; Toxicity: respiratory system, ent, stomatology
• ISSN: 0954-6111; 1532-3064
• DOI: 10.1016/S0954-6111(97)90062-7

Pulmonary microvascular injury has become a recently studied phenomenon that may be responsible for most of the complications associated with the lungs. Thirty patients undergoing partial hemilaminectomy or discectomy due to hernia of nucleus pulposus underwent Tc-99m HMPAO lung clearance as well as Tc-99m pertechnetate lung scintigraphy pre-operatively, and following general anaesthesia with halothane and isoflurane (third, fourth and tenth post-operative days). The results were compared with conventional techniques and haemodynamic parameters during the peri-operative period. In order to demonstrate acute phase changes under general anaesthesia and to perform pathological examinations, 21 New Zealand rabbits underwent radionuclide studies with Tc-99m HMPAO or Tc-99m pertechnetate. Lung biopsies were also performed. Despite no significant differences in any of the conventional diagnostic techniques, Tc-99m pertechnetate lung scintigraphy was performed for both the halothane and isoflurane groups, and Tc-99m HMPAO lung clearance was performed for the isoflurane group preor post-operatively. Tc-99m HMPAO lung clearance was impaired significantly in the halothane group on the third post-operative day (half time: 6·4 ± 1·6 pre-operative and 13·76 ± 3·3 s, P