Effects of Isoflurane on the Baroreceptor Reflex

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Abstract
The effects of isoflurane on each component of the baroreceptor reflex arc was studied, including the receptors, afferent and efferent nerve pathways, central integratory centers, peripheral ganglia and the heart. Baroreflex effects on heart rate initiated by systemic pressure changes were examined in conscious and anesthetized dogs (1.3% and 2.6% isoflurane). The effects on individual components of the reflex arc were determined by examining carotid sinus baroreceptor afferent activity, sympathetic efferent nerve activity as well as heart rate response to direct sympathetic and parasympathetic efferent nerve stimulation in anesthetized dogs. Preganglionic and postganglionic nerve activities were recorded simultaneously during baroreflex activation to determine ganglionic effects of isoflurane. Baroreflex-induced changes in heart rate were not depressed significantly until 2.6% isoflurane if blood pressure changes due to anesthetic administration were prevented. Significant decreases in baseline sympathetic efferent nerve activity occurred at 1.3% and 2.6% isoflurane, with depression of postganglionic activity significantly greater than preganglionic activity at 2.6% isoflurane, indicating a ganglionic effect of isoflurane. Cardiac chronotropic responses to direct stimulation of sympathetic and vagal fibers were attenuated significantly by isoflurane, with sympathetic stimulation showing the greater sensitivity to the anesthetic. Carotid baroreceptor afferent activity was increased by isoflurane; this sensitization of the baroreceptors appeared to contribute to the decreased levels of sympathetic tone. Although isoflurane altered the baroreceptor reflex through its effects at multiple sites of the baroreflex arc, significant depression of the cardiac chronotropic component of the reflex was seen only at 2.6% isoflurane.