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2002, Número 1

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Rev Mex Anest 2002; 25 (1)


Determinación de la dosis efectiva de Sevofluorano capaz de bloquear la respuesta hipertensiva durante laparoscopia.

Tamariz-Cruz O. , Reza A. , Zaragoza J. , Gaona C. , Ulibarri M. , Perales E

Idioma: Español
Referencias bibliográficas: 19
Paginas: 24-28
Archivo PDF: 123.32 Kb.


RESUMEN

Background: Vasopressin (VP) was recently identified as a major modulator of hypertension during laparoscopy (LAP). We searched for the effective dose (ED) of sevoflurane (S) with and without N2O able to control hemodynamic response (CHR) during LAP. Material and Methods: The study was developed in five Mexican states, including ASA I patients divided in two groups: G I: S plus 60% N2O (n=88) and G II: S alone (n=72). Conventional monitoring along BIS was used and basal data were recorder. Blood samples for nor epinephrine (NE) determination were drawn basal, 3´ after endotracheal intubation and 10´ after sustained insufflation (SI) and for VP basal, after hydration and 3´ after SI. The range of S for ED determination was 0.5 to 4% for both groups, as measured in Et concentration. Identification of the ED50-95 of S for CHR during LAP was done using Waud´s method. Results: No demographic differences were observed between groups except for gender. ED50 of S for G I was 1.5 +/- 0.3 and for G II 2.0 +/- 0.32. ED95 were 2.0 +/- 0.4 and 3.0 +/- 0.27 respectively. No differences in hemodynamic behavior were observed for ED50 or 95 between groups. Plasma VP levels were significantly lower in N2O supplemented patients (6.4 vs. 97.3 pg/ml). Adequacy of anesthetic depth was observed in all cases for ED 50-95 . Discussion: The ED50-95 of S for CHR during LAP with and without N2O are described. A different dose of the one described for open procedures is reported. Neuroendocrine behavior is likely to be the explanation for this difference.


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