Efeitos do halotano, sevoflurano e isoflurano nas funções cardiovasculares e renal em cães submetidos a choque hemorrágico
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Data
2008-12-19
Autores
Silva, Alexandre Evangelista [UNESP]
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
Os anestésicos inalatórios halogenados podem apresentar papel importante na patogênese das alterações cardiocirculatórias e renais durante o choque hemorrágico por alterarem, de maneira dose dependente, os mecanismos de defesa compensatórios. O presente estudo teve como objetivo comparar os efeitos de uma concentração alveolar mínima (CAM) de halotano, sevoflurano e isoflurano sobre o sistema cardiovascular e renal em cães submetidos a choque hemorrágico e reposição volêmica com o sangue retirado do animal. O estudo aleatório foi realizado em trinta cães, sem raça definida, distribuídos em três grupos de acordo com o anestésico inalatório halogenado utilizado durante a anestesia, em concentrações eqüipotentes de uma CAM: GH (n=10) - halotano a 0,89%; GS (n=10) - sevoflurano a 2,4%; e GI (n=10) - isoflurano a 1,4%. Todos os cães foram ventilados mecânicamente, esplenectomizados e submetidos a sangramento, com retirada em torno de 40% do volume sangüíneo, visando manter a pressão arterial média de 40 a 50 mm Hg durante 45 minutos. A seguir, os cães foram submetidos à expansão volêmica com o sangue removido. Os atributos hemodinâmicos foram determinados no momento controle, após 45 minutos de hemorragia, e 15 e 60 minutos após a reposição sangüínea. Os atributos renais foram medidos nos mesmos momentos, exceto no período hemorrágico, pela ausência de diurese. No momento controle, a maioria das variáveis hemodinâmicas e renais foram semelhantes entre os grupos, com exceção da fração de filtração, cujos valores foram menores no grupo GI, em relação aos grupos GH e GS (p < 0,05), e da osmolalidade urinária, cujos valores foram maiores no grupo GS, em comparação com o grupo GH (p < 0,05). Após a hemorragia...
Halogenated anesthetics may play an important role in the pathogenesis of cardiovascular and renal changes during hemorrhagic shock because they modify, in a dose-dependent manner, compensatory defense mechanisms. The aim of the present study was to compare the effects of a minimum alveolar concentration (MAC) of halothane, sevoflurane and isoflurane on the cardiovascular and renal systems of dogs subjected to hemorrhagic shock followed by restoration of blood volume with shed blood. Thirty mongrel dogs were randomly distributed into three groups according to the halogenated anesthetic used for anesthesia. They were anesthetized with halothane (H group; n=10), sevoflurane (S group; n=10) or isoflurane (I group; n=10) and anesthesia was maintained at 1.0 MAC: 0.89%, 2.4%, and 1.4%, respectively. All the dogs were mechanically ventilated, splenectomized and subjected to bleeding with 40% blood reduction to keep mean arterial pressure between 40 and 50 mm Hg for 45 min. Thereafter, the dogs were resuscitated with shed blood. The hemodynamic attributes were determined at the control moment, after 45 min of hemorrhage, 15 and 60 min after restoration of blood volume. The renal attributes were determined at the described moments, except during the hemorrhage period, for lack of diuresis. At the control moment, most of the hemodynamic and renal variables were similar among the groups, except for the filtered fraction, Introdução e Literatura 11 which was lower in GI than in groups GH and GS (p < 0.05), and for urinary osmolarity, which was higher in GS compared to GH (p < 0.05). After hemorrhage, the hemodynamic attributes decreased, without significant differences among the groups (p > 0.05). Fifteen minutes after resuscitation, most of the hemodynamic and renal attributes were... (Complete abstract click electronic access below)
Halogenated anesthetics may play an important role in the pathogenesis of cardiovascular and renal changes during hemorrhagic shock because they modify, in a dose-dependent manner, compensatory defense mechanisms. The aim of the present study was to compare the effects of a minimum alveolar concentration (MAC) of halothane, sevoflurane and isoflurane on the cardiovascular and renal systems of dogs subjected to hemorrhagic shock followed by restoration of blood volume with shed blood. Thirty mongrel dogs were randomly distributed into three groups according to the halogenated anesthetic used for anesthesia. They were anesthetized with halothane (H group; n=10), sevoflurane (S group; n=10) or isoflurane (I group; n=10) and anesthesia was maintained at 1.0 MAC: 0.89%, 2.4%, and 1.4%, respectively. All the dogs were mechanically ventilated, splenectomized and subjected to bleeding with 40% blood reduction to keep mean arterial pressure between 40 and 50 mm Hg for 45 min. Thereafter, the dogs were resuscitated with shed blood. The hemodynamic attributes were determined at the control moment, after 45 min of hemorrhage, 15 and 60 min after restoration of blood volume. The renal attributes were determined at the described moments, except during the hemorrhage period, for lack of diuresis. At the control moment, most of the hemodynamic and renal variables were similar among the groups, except for the filtered fraction, Introdução e Literatura 11 which was lower in GI than in groups GH and GS (p < 0.05), and for urinary osmolarity, which was higher in GS compared to GH (p < 0.05). After hemorrhage, the hemodynamic attributes decreased, without significant differences among the groups (p > 0.05). Fifteen minutes after resuscitation, most of the hemodynamic and renal attributes were... (Complete abstract click electronic access below)
Descrição
Palavras-chave
Anestesia, Cão - Anestesia - Efeitos fisiológicos, Hemorrhagic shock
Como citar
SILVA, Alexandre Evangelista. Efeitos do halotano, sevoflurano e isoflurano nas funções cardiovasculares e renal em cães submetidos a choque hemorrágico. 2008. 154 f. Tese (doutorado) - Universidade Estadual Paulista, Faculdade de Medicina de Botucatu, 2008.