Journal of Clinical Anesthesia
Volume 7, Issue 4 , Pages 281-287 , June 1995

Cardiovascular reflexes during anesthesia induction and tracheal intubation in elderly patients: The influence of thoracic epidural anesthesia

  • Marc Licker, MD

      Affiliations

    • Corresponding Author InformationAddress reprint requests to Dr. Licker at the Division of Surgical and Anesthesiological Investigations, University Hospital, rue Micheli-Ducrest, CH 1211 Geneva 14, Switzerland.
    • Research Fellow in Anesthesiology.
    • ,
  • Cedric Farinelli, PhD

      Affiliations

    • Assistant in Physiology.
    • ,
  • Claude-Eric Klopfenstein, MD

      Affiliations

    • Assistant in Physiology.

Received 5 November 1993 ,Accepted 6 July 1994.

References 

  1. Kehlet H. Surgical stress: the role of pain and analgesia. Br J Anaesth. 1989;63:189–195
  2. Yeager MP, Glass DD, Neff RK, Brinck-Johnsen T. Epidural anesthesia and analgesia in high-risk surgical patients. Anesthesiology. 1987;66:729–736
  3. King B, Harris L, Greifenstein FE, Elder JD, Dripps RD. Reflex circulatory response to direct laryngoscopy and intubation erformed during general anesthesia. Anesthesiology. 1951;12:121–128
  4. Thomson IR. The haemodynamic response to intubation: a perspective. Can J Anaesth. 1989;36:367–369
  5. Harris T, Cook EF, Kannel W, Schatzkin A, Goldman L. Blood pressure experience and the risk of cardiovascular disease in the elderly. Hypertension. 1985;7:118–124
  6. Pagani M, Lombardi F, Guzzetti S, et al.  Power spectral analysis of heart rate and arterial pressure variabilities as a marker of sympatho-vagal interaction in man and conscious dog. Circ Res. 1986;59:178–193
  7. Muzi M, Ebert T. Quantification of heart rate variability with power spectral analysis. Current Opinion in Anesthesiology. 1993;6:3–17
  8. Kaukenas J. Concerning the estimation of order and parameters of the autoregression model. In: 2d ed.. Statistical problems of Management. 63:Vylnius, Lithuania: Institute of Mathematics and Cybernetics, University of Vylnius; 1983;p. 46–61
  9. Sandroni P, Benarroch EE, Low PA. Pharmacological dissection of components of the Valsalva maneuver in adrenergic failure. J Appl Physiol. 1991;71:1563–1567
  10. Goertz AW, Seeling W, Heinrich H, Lindner KH, Schirmer U. Influence of high thoracic epidural anesthesia on left ventricular contractility assessed using the end-systolic pressure-length relationship. Acta Anaesthesiol Scand. 1993;37:38–44
  11. Lynch C. Depression of myocardial contractility in vitro by bupivacaine, etidocaine, and lidocaine. Anesth Analg. 1986;65:551–559
  12. Hopf HB, Arand D, Peters J. Sympathetic blockade by thoracic epidural anaesthesia suppresses renin release in response to hypotension, but activates the vasopressin system. Eur J Anaesthesiol. 1992;9:63–69
  13. Mangano DT. Perioperative cardiac morbidity. Anesthesiology. 1990;72:153–184
  14. Hassan HG, El-Sharkawy TY, Renck H, Mansour G, Fouda A. Hemodynamic and catecholamine responses to laryngoscopy with vs. without endotracheal intubation. Acta Anaesthesiol Scand. 1991;35:442–447
  15. Bullington J, Mouton Perry SM, Ribby J, et al.  The effect of advancing age on the sympathetic response to laryngoscopy and tracheal intubation. Anesth Analg. 1989;68:603–608
  16. Blomberg S, Emmanuelson H, Rickstein SE. Thoracic epidural anesthesia and central hemodynamics in patients with unstable angina pectoris. Anesth Analg. 1989;69:558–562
  17. Ottesen S. The influence of thoracic epidural analgesia on the circulation at rest and during physical exercise in man. Acta Anaesthesiol Scand. 1978;22:537–547
  18. Sundberg A, Wattwil M. Circulatory effects of short-term hypercapnia during high thoracic epidural anaesthesia in elderly patients. Acta Anaesthesiol Scand. 1987;31:81–86
  19. Dohi S, Nishikawa T, Ujike Y, Mayumi T. Circulatory responses to airway stimulation and cervical epidural blockade. Anesthesiology. 1982;57:359–363
  20. Wattwil M, Sundberg A, Olsson J, Nordström S. Thoracolumbar epidural anaesthesia blocks the circulatory response to laryngoscopy and intubation. Acta Anaesthesiol Scand. 1987;31:529–531
  21. Lundin S, Kirnö K, Wallin BG, Elam M. Effects of epidural anesthesia on sympathetic nerve discharge to the skin. Acta Anaesthesiol Scand. 1990;34:492–497
  22. Dahl JB, Rosenberg J, Kehlet H. Effect of thoracic epidural etidocaine 1.5% on somatosensory evoked potentials, cortisol and glucose during cholecystectomy. Acta Anaesthesiol Scand. 1992;36:378–382
  23. Gissen AJ, Covino BG, Gregus J. Differential sensitivities of mammalian nerve fibers to local anesthetic agents. Anesthesiology. 1980;53:467–474
  24. Takeshima R, Dohi S. Circulatory responses to baroreflexes, Valsalva maneuver, coughing, swallowing, and nasal stimulation during acute cardiac sympathectomy by epidural blockade in awake humans. Anesthesiology. 1985;63:500–508
  25. Kingwell BA, McPherson GA, Korner PI. Assessment of gain of tachycardia and bradycardia responses of cardiac baroreflex. Am J Physiol. 1991;260(4):H1254–H1263 Pt2
  26. Hayward L, Hay M, Felder RB. Acute resetting of the carotid sinus baroreflex by aortic depressor nerve stimulation. Am J Physiol. 1993;264(4):H1215–H1222 Pt2
  27. Sellgren J, Biber B, Henriksson BA, Martner J, Ponten J. The effects of propofol, methohexitone and isoflurane on the baroreceptor reflex in the cat. Acta Anaesthesiol Scand. 1992;36:784–790
  28. Watkins L, Maixner W. The effect of pentobarbital anesthesia on the autonomic nervous system control of heart rate during baroreceptor activation. J Auton Nerv Syst. 1991;36:107–114
  29. Donchin Y, Feld JM, Porges SW. Respiratory sinus arrhythmia during recovery from isoflurane-nitrous oxide anesthesia. Anesth Analg. 1985;64:811–815
  30. Kato M, Komatsu T, Kimura T, Sugiyama F, Nakashima K, Shimada Y. Spectral analysis of heart rate variability during isoflurane anesthesia. Anesthesiology. 1992;77:669–674
  31. Malliani A, Pagani M, Lombardi F, Cerutti S. Cardiovascular neural regulation explored in the frequency domain. Circulation. 1991;84:482–490
  32. Brown BG, Bolson EL, Dodge HT. Dynamic mechanisms in human coronary stenosis. Circulation. 1984;70:917–922

☆ Supported by a grant from the Carlos and Elsie De Reuter Foundation, Geneva, Switzerland.

PII: 0952-8180(95)00025-D

Journal of Clinical Anesthesia
Volume 7, Issue 4 , Pages 281-287 , June 1995

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