Isoflurano em emulsão lipídica por via venosa promove estabilidade cardiovascular respiratória em modelo experimental

Lígia Andrade da Silva Telles Mathias; Luiz Piccinini Filho; José Carlos Rittes; Flávia Salles Souza; José Ricardo Pinotti Pedro; Wagner Cirillo; Joaquim Edson Vieira

doi:10.1590/S0034-70942004000500005

Scientific Article

Isoflurano em emulsão lipídica por via venosa promove estabilidade cardiovascular respiratória em modelo experimental

Intravenous isoflurane in lipid emulsion promotes cardiovascular and respiratory stability. Experimental model

Lígia Andrade da Silva Telles Mathias; Luiz Piccinini Filho; José Carlos Rittes; Flávia Salles Souza; José Ricardo Pinotti Pedro; Wagner Cirillo; Joaquim Edson Vieira

http://dx.doi.org/10.1590/S0034-70942004000500005 Braz J Anesthesiol, vol.54, n5, p.650-662, 2004

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Resumo

JUSTIFICATIVA E OBJETIVOS: A administração venosa de anestésico inalatório pode causar lesão pulmonar. Halotano em solução lipídica por via venosa promove anestesia com estabilidade hemodinâmica e respiratória. Esta pesquisa procurou estabelecer a dose de indução para emulsão lipídica de isoflurano a 10% e observar as condições cardiovasculares e respiratórias, em anestesia experimental. MÉTODO: Sete porcos machos foram selecionados. Os animais receberam infusão de propofol para as preparações cirúrgicas invasivas: dissecção de artéria femoral e veia jugular, sensor de ecodopplercardiografia no esôfago. Foram registrados freqüência cardíaca (FC), eletrocardiograma (ECG), pressão arterial sistólica (PAS), diastólica (PAD), média (PAM), venosa central (PVC), índice cardíaco (IC), débito cardíaco (DC) e índice bispectral (BIS). As frações inspirada e expirada dos gases respiratórios foram analisadas continuamente. Iniciada infusão da emulsão lipídica de isoflurano até o índice bispectral atingir valor de 40 ± 5 (BIS40). Os animais foram mantidos anestesiados e submetidos a laparotomia exploradora para sutura gástrica. RESULTADOS: O volume total infundido para atingir BIS40 foi 25,6 ± 11,2 ml (2,56 ml de isoflurano). O tempo médio para atingir BIS40 foi 15,6 ± 6,9 minutos. Maior velocidade de infusão reduziu o tempo para os animais atingirem BIS40. Condições cardiovasculares e respiratórias mostraram-se estáveis durante a experimentação. A freqüência cardíaca aumentou com a elevação da fração expirada do isoflurano. CONCLUSÕES: A infusão venosa do isoflurano em solução emulsificada promoveu diminuição do índice bispectral, estabilidades hemodinâmica e respiratória e correlação direta com sua fração expirada. O uso do isoflurano em emulsão lipídica pode se constituir em modalidade segura de aplicação deste anestésico.

Palavras-chave

ANESTESIA, ANESTESIA, ANESTÉSICOS, ANESTÉSICOS, ANIMAL, FARMACOTÉCNICA

Abstract

BACKGROUND AND OBJECTIVES: Intravenous infusion of inhalation anesthetics may promote lung injury. Intravenous halothane in lipid emulsion induces anesthesia with hemodynamic and respiratory stability. This investigation aimed at establishing the induction dose of isoflurane in 10% lipid emulsion and at observing cardiovascular and respiratory effects in experimental anesthesia. METHODS: This study involved 7 male piglets. Animals received intravenous propofol for invasive surgical preparations: femoral artery and jugular vein dissection and esophageal ecodopplercardiographic sensor. Heart rate (HR), electrocardiography (ECG), systolic (SBP), diastolic (DBP), mean (MBP) blood pressure and central venous pressure (CVP), cardiac index (CI) and bispectral index (BIS) were recorded. Inspired and expired gases fractions were continuously evaluated. Isoflurane lipid emulsion was injected until bispectral index had decreased to 40 ± 5 (BIS40). Animals were kept anesthetized and submitted to laparotomy for gastric suture. RESULTS: Total volume to reach BIS40 was 25.6 ± 11.2 mL (2.56 mL isoflurane). Mean time to reach BIS40 was 15.6 ± 6.9 minutes. The higher the infusion rate the shorter the time to reach BIS40. Cardiovascular and respiratory conditions were stable throughout the experiment. Heart rate has increased with increased end tidal isoflurane. CONCLUSIONS: Intravenous isoflurane in lipid emulsion has promoted bispectral index decrease, hemodynamic and respiratory stability and direct correlation with its expired fraction. Intravenous isoflurane in lipid emulsion may be a safe modality for this anesthetic delivery.

Keywords

ANESTHESIA, ANESTHESIA, ANESTHETICS, ANESTHETICS, ANIMAL, PHARMACOTECHNIQUE

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Isoflurano em emulsão lipídica por via venosa promove estabilidade cardiovascular respiratória em modelo experimental

Intravenous isoflurane in lipid emulsion promotes cardiovascular and respiratory stability. Experimental model

Lígia Andrade da Silva Telles Mathias; Luiz Piccinini Filho; José Carlos Rittes; Flávia Salles Souza; José Ricardo Pinotti Pedro; Wagner Cirillo; Joaquim Edson Vieira

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