thesis

Veränderung der Hämodynamik durch die Kombinationsnarkose aus Xenon und Isofluran im Vergleich zu der aus Xenon und Sevofluran an Schweinen

Abstract

Measurements to the described hemodynamic parameters in mono-anesthesia with isoflurane or sevoflurane were taken as baseline values. Therefore the volatile anesthetics were administered at 1.0, 1.3 and 1.6 MAC. After that measurements together with xenon and one of the volatiles were performed. Xenon was delivered at increasing levels (15%, 30%, 40%, 50% and 65%) and each xenon concentration was combined with the volatiles at 1.0, 1.3, 1.6 MAC in a stepwise design. The parameters heart rate (HR), mean arterial pressure (MAP), cardiac output (CO) and systemic vascular resistence (TPR) were examined due to significant changes by administering different combinations of xenon together with isoflurane or sevoflurane. As a result the parameters are significantly changed only at high levels of xenon. In our study heart rate was decreased by using increased concentrations of both volatile anesthetics in mono-anesthesia due to a higher level of anesthesia. We suggest a “time-effect” because each pig in both groups shows continuously increasing values for heart rate according to the very long duration of the examination. The other parameters show no “time-effect”. The combination of xenon with isoflurane shows a significant increase of CO of 18% at 1.3 MAC and about 23.3 % at 1.6 MAC in 65% xenon. With use of sevoflurane increasing levels of CO are seen at first with 50 % xenon. They are about 25.2 % at 1.3 MAC and 34.6% at 1.6 MAC. There is a continuous increase in CO when using 1.6 MAC sevoflurane with each xenon concentration. The study shows significant increase in MAP when using isoflurane at 1.3 and 1.6 MAC together with all different xenon concentrations. When using sevoflurane we see this effect at 1.6 MAC. The study examined no significant alterations in TPR in mono-anesthesia. When using the combination with xenon the results were not uniform. In conclusion the combination of xenon together with isoflurane or sevoflurane can influence the hemodynamic situation in a positive matter when xenon is administered in a high concentration. In this study this effect can be seen for both volatile anesthetics when xenon is used at a concentration of 65%. There is an advantage for sevoflurane because the effect is also seen when xenon is administered only at 50%. In a matter of balanced anesthesia the combination of xenon with volatile anesthetics might stabilizise the hemodynamic situation by reducing volatiles MAC. Xenon itself has no adverse side effects. This form of anesthesia is favorable for patients with reduced cardiovascular compliance because they need a very high grade of cardiovascular stability and a high concentration of inspired oxygen

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