T Ishikawa1, J Sato, T Nishino. 1. Department of Anesthesiology, Chiba University School of Medicine, Japan. iteru@anesth01.m.chiba-u.ac.jp
Abstract
PURPOSE: To examine whether changes in bladder volume elicit reflex cardiovascular and respiratory responses in humans under general anesthesia with sevoflurane and nitrous oxide. METHODS: Fourteen patients free of autonomic disorders were anesthetized with sevoflurane 0.5% and nitrous oxide 60% in oxygen that were approximately equivalent to 0.9 MAC. Warmed saline (6 ml x kg(-1), 37 degrees C) was instilled into the pre-emptied urinary bladder, and then the bladder was kept distended for five minutes. Following the distension, the instilled saline was drained to the pre-instilled volume of the bladder Arterial blood pressure, respiratory flow, and intra-vesicle pressure were continuously measured, and mean arterial pressure, pulse rate, respiratory rate, tidal volume, and minute ventilation were estimated offline from these signals. RESULTS: Bladder emptying produced small decreases in mean blood pressure (from 83.4+/-4.3 to 80.0+/-4.4 mm Hg, mean +/- SE, P = 0.017) and pulse rate (from 72.2+/-2.9 to 69.4+/-2.7 bpm, mean +/- SEM, P = 0.004). Only minimal respiratory reflexes were invoked by the bladder volume changes. CONCLUSION: In lightly anesthetized humans, the acute changes in bladder volume produce only mild cardiovascular and respiratory responses.
PURPOSE: To examine whether changes in bladder volume elicit reflex cardiovascular and respiratory responses in humans under general anesthesia with sevoflurane and nitrous oxide. METHODS: Fourteen patients free of autonomic disorders were anesthetized with sevoflurane 0.5% and nitrous oxide 60% in oxygen that were approximately equivalent to 0.9 MAC. Warmed saline (6 ml x kg(-1), 37 degrees C) was instilled into the pre-emptied urinary bladder, and then the bladder was kept distended for five minutes. Following the distension, the instilled saline was drained to the pre-instilled volume of the bladder Arterial blood pressure, respiratory flow, and intra-vesicle pressure were continuously measured, and mean arterial pressure, pulse rate, respiratory rate, tidal volume, and minute ventilation were estimated offline from these signals. RESULTS: Bladder emptying produced small decreases in mean blood pressure (from 83.4+/-4.3 to 80.0+/-4.4 mm Hg, mean +/- SE, P = 0.017) and pulse rate (from 72.2+/-2.9 to 69.4+/-2.7 bpm, mean +/- SEM, P = 0.004). Only minimal respiratory reflexes were invoked by the bladder volume changes. CONCLUSION: In lightly anesthetized humans, the acute changes in bladder volume produce only mild cardiovascular and respiratory responses.