Po-Kai Wang a, Tzong-Bor Sun b, c, Kun-Ruey Shieh b, d, Chia-Ling Lee a, Jimmy Ong a, Ming-Hwang Shyr a, Tsung-Ying Chen a, e
aDepartment of Anesthesiology, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, Taiwan
bInstitute of Physiological and Anatomical Medicine, Tzu Chi University, Hualien, Taiwan
cDepartment of Surgery, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
dInstitute of Neuroscience, Tzu Chi University, Hualien, Taiwan
eGraduate Institute of Clinical Medicine, Tzu Chi University, Hualien, Taiwan
Abstract
Objective
Inhalation anesthetics increase heart rate (HR) in vivo in both animals and humans but decrease heart rate in isolated hearts. Clinical studies indicate that insulin-dependent diabetes mellitus is associated with alterations in autonomic nervous system control of cardiovascular function. The specific aim of this study was to elucidate the effects of different inhalation anesthetics on cardiovascular autonomic function in diabetic rats.
Materials and Methods
We measured blood pressure variability (BPV) in streptozotocin (STZ, 60 mg/kg, i.p.)-induced diabetic Sprague-Dawley rats and vehicle control groups exposed to different inhalation anesthetics (halothane, desflurane and sevoflurane) and BPV was recorded until the recovery stage. Frequency-domain analysis of telemetric systemic arterial pressure and pulse-pulse interval were applied to quantify the parameters of BPV. High frequency power (HF) was regarded as cardiac vagal modulation. Low frequency power of BPV (BLF) was referred to as vascular sympathetic modulation. Normalized low-frequency power (LF%) of the spectrogram of the RR interval was regarded as cardiac sympathetic modulation.
Results
STZ-induced diabetes was associated with a significant reduction of HR but not consistently with a higher HF among these volatile anesthetics. BLF was significantly decreased at one minimum alveolar concentration (MAC) of desflurane when compared with halothane and sevoflurane in the STZ-induced diabetic group. We found an early recovery of the BLF to awake stage baseline values 30 minutes post-anesthesia for sevoflurane, although it was not significant when compared with the other two anesthetics. However, the LF% significantly recovered to 80% of awake baseline values with desflurane and sevoflurane when compared with halothane 30 minutes post-anesthesia.
Conclusion
The components of sympathetic regulation (BLF and LF%) may be an early sign of hemodynamic recovery to the awake stage during anesthesia in STZ-induced diabetic rats. Our results provide an indication for clinical anesthetic choice in diabetes patients receiving anesthesia.
Keywords
Blood pressure variability; Diabetes mellitus; Rats; Volatile anesthetics
