Baroreflex control of heart rate during high thoracic epidural anaesthesia : a randomised clinical trial on anaesthetised humans

Baroreflex control of heart rate after cardiac sympathectomy induced by thoracic epidural anaesthesia was evaluated in 30 patients who were randomly assigned to group 1 (bupivacaine 0.25%), group 2 (bupivacaine 0.5%) or group 3 (control). Plasma volume expanders were given to equalize preload condit...

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Bibliographic Details
Published in:Anaesthesia 1992-11, Vol.47 (11), p.984-987
Main Authors: GOERTZ, A, HEINRICH, H, SEELING, W
Format: Article
Language:English
Subjects:
Adult
Anesthesia
Anesthesia, Epidural
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Biological and medical sciences
Blood Pressure - drug effects
Bupivacaine - administration & dosage
Bupivacaine - pharmacology
Heart Rate - physiology
Humans
Local anesthesia. Pain (treatment)
Medical sciences
Middle Aged
Pressoreceptors - physiology
Reflex - drug effects
Reflex - physiology
Sympathetic Nervous System - physiology
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Summary:Baroreflex control of heart rate after cardiac sympathectomy induced by thoracic epidural anaesthesia was evaluated in 30 patients who were randomly assigned to group 1 (bupivacaine 0.25%), group 2 (bupivacaine 0.5%) or group 3 (control). Plasma volume expanders were given to equalize preload conditions, as assessed using transoesophageal echocardiography. All measurements were made under general anaesthesia. Baroreflex sensitivity was determined from the heart rate response to phenylephrine and nitroglycerin. There was no difference in cardiac slowing in response to phenylephrine between the three groups. Baroreflex sensitivity, measured as cardiac acceleration in response to nitroglycerin, was significantly lower (p < 0.01) in groups 1 and 2 (1.8 and 1.5 ms.mmHg-1 respectively) compared with group 3 (3.5 ms.mmHg-1) with no differences between the two bupivacaine concentrations. The results suggest that baroreflex-mediated response to decreases in arterial pressure is dependent on the integrity of the sympathetic nervous system.
ISSN:0003-2409
1365-2044
DOI:10.1111/j.1365-2044.1992.tb03206.x