Halothane, enflurane, and isoflurane depress the peripheral vagal motor pathway in isolated canine tracheal smooth muscle.Brichant, Jean-François ; ; et alin Anesthesiology (1991), 74(2), 325-32 Volatile anesthetics are potent bronchodilators, but the site of action for the dilation is unclear. To determine the site of action of halothane, enflurane, and isoflurane on the peripheral vagal motor ... [more ▼] Volatile anesthetics are potent bronchodilators, but the site of action for the dilation is unclear. To determine the site of action of halothane, enflurane, and isoflurane on the peripheral vagal motor pathway, isolated strips of canine trachealis muscle were stimulated before and during exposure to halothane at 0.3, 1.0, 1.7, or 2.4 MAC, enflurane at 1 MAC, or isoflurane at 1 MAC. The sites and methods of stimulation were: 1) postsynaptic nicotinic cholinergic receptors in the intramural parasympathetic ganglia, with 1,1-dimethyl-4-phenyl-piperazinium iodide (DMPP); 2) postganglionic cholinergic nerve fibers, with electrical field stimulation (EFS); and 3) muscarinic cholinergic receptors of the smooth muscle, with acetylcholine (ACh). The concentration-response curve to DMPP was significantly shifted to the right by 0.3 MAC halothane, whereas 0.3 MAC halothane had no significant effect on the concentration-response curves to ACh and EFS. At concentrations greater than 1 MAC of halothane, enflurane, or isoflurane, concentration-response curves to all three stimuli were shifted significantly to the right; i.e., the contractile responses to ACh, EFS, and DMPP were reduced. At all concentrations of halothane the force of contraction was significantly more reduced during stimulation with DMPP than during stimulation with ACh, and at halothane concentrations greater than or equal to 1.7 MAC the response to EFS was significantly more reduced than that to ACh. We conclude that halothane, enflurane, and isoflurane attenuated airway constriction by several mechanisms, including 1) reduced excitability of the postsynaptic nicotinic receptors of the intramural parasympathetic ganglia and 2) an effect on the smooth muscle and/or on the muscarinic receptors.(ABSTRACT TRUNCATED AT 250 WORDS) [less ▲] Detailed reference viewed: 15 (0 ULg) Chest wall motion during epidural anesthesia in dogs.; Brichant, Jean-François ; et alin Journal of Applied Physiology (Bethesda, Md. : 1985) (1991), 70(2), 539-47 To determine the relative contribution of rib cage and abdominal muscles to expiratory muscle activity during quiet breathing, we used lumbar epidural anesthesia in six pentobarbital sodium-anesthetized ... [more ▼] To determine the relative contribution of rib cage and abdominal muscles to expiratory muscle activity during quiet breathing, we used lumbar epidural anesthesia in six pentobarbital sodium-anesthetized dogs lying supine to paralyze the abdominal muscles while leaving rib cage muscle motor function substantially intact. A high-speed X-ray scanner (Dynamic Spatial Reconstructor) provided three-dimensional images of the thorax. The contribution of expiratory muscle activity to tidal breathing was assessed by a comparison of chest wall configuration during relaxed apnea with that at end expiration. We found that expiratory muscle activity was responsible for approximately half of the changes in thoracic volume during inspiration. Paralysis of the abdominal muscles had little effect on the pattern of breathing, including the contribution of expiratory muscle activity to tidal breathing, in most dogs. We conclude that, although there is consistent phasic expiratory electrical activity in both the rib cage and the abdominal muscles of pentobarbital-anesthetized dogs lying supine, the muscles of the rib cage are mechanically the most important expiratory muscles during quiet breathing. [less ▲] Detailed reference viewed: 19 (0 ULg) Direct and neurally mediated effects of halothane on pulmonary resistance in vivo.; ; Brichant, Jean-François et alin Anesthesiology (1990), 72(6), 1057-63 It has been suggested that halothane inhibits contraction of airway smooth muscle in vivo mainly by reducing reflex activity in nerves innervating the muscle with only minimal direct effects on the muscle ... [more ▼] It has been suggested that halothane inhibits contraction of airway smooth muscle in vivo mainly by reducing reflex activity in nerves innervating the muscle with only minimal direct effects on the muscle itself. To examine possible mechanisms of action of halothane at clinically relevant concentrations the authors studied the effect of halothane on increases in pulmonary resistance (RL) produced by either vagus nerve stimulation (VNS, which caused neurally mediated constriction) or the inhalation of nebulized acetylcholine (ACh, which directly stimulated the smooth muscle cell) in nine mongrel dogs. The frequency of bilateral VNS and the dose of nebulized ACh were adjusted to produce approximately equal increases in RL. Halothane reduced the response to both types of stimulation in a dose-dependent fashion. At halothane concentrations greater than or equal to 0.4 MAC, the VNS response was significantly less than the ACh response. When tetrodotoxin was given to block neural activity, the ACh response was unchanged, confirming that neural activation did not contribute significantly to smooth muscle contraction in response to ACh. The authors conclude that in addition to neurally mediated effects, halothane at clinically used concentrations has significant direct effects on airway smooth muscle stimulated by ACh. The relative importance of each factor in vivo should depend on the stimulus that causes contraction of airway smooth muscle. [less ▲] Detailed reference viewed: 2 (0 ULg) Muscarinic receptor subtypes in canine trachea.Brichant, Jean-François ; ; et alin American Journal of Physiology (1990), 258(6 Pt 1), 349-54 Prejunctional and postjunctional muscarinic receptor subtypes were characterized in canine trachealis muscle strips. In vitro contractile responses of muscle strips to acetylcholine or electric field ... [more ▼] Prejunctional and postjunctional muscarinic receptor subtypes were characterized in canine trachealis muscle strips. In vitro contractile responses of muscle strips to acetylcholine or electric field stimulation were determined in the absence and the presence of gallamine, pirenzepine, and 4-diphenylacetoxy-N-methylpiperidine methiodide (4-DAMP). Gallamine had no effect on the contractile response to acetylcholine but enhanced the contractile response to electric field stimulation. Pirenzepine and 4-DAMP reduced the contractile response to acetylcholine and electric field stimulation. The pA2 value for pirenzepine vs. acetylcholine [7.18 +/- 0.59 (SD)] was consistent with the affinity of pirenzepine for M2 or M3-receptors; whereas the pA2 value for 4-DAMP vs. acetylcholine (8.92 +/- 0.42) and the extremely low affinity of gallamine indicated postjunctional muscarinic receptors of the M3 subtype. The enhancement of the contractile response to electric field stimulation by gallamine suggested the presence of M2-prejunctional receptors. [less ▲] Detailed reference viewed: 14 (0 ULg) Halothane decreases both tissue and airway resistances in excised canine lungs.; ; Brichant, Jean-François et alin Journal of Applied Physiology (Bethesda, Md. : 1985) (1989), 66(6), 2698-703 Studies of the anesthetic effects on the airway often use pulmonary resistance (RL) as an index of airway caliber. To determine the effects of the volatile anesthetic, halothane, on tissue and airway ... [more ▼] Studies of the anesthetic effects on the airway often use pulmonary resistance (RL) as an index of airway caliber. To determine the effects of the volatile anesthetic, halothane, on tissue and airway components of RL, we measured both components in excised canine lungs before and during halothane administration. Tissue resistance (Rti), airway resistance (Raw), and dynamic lung compliance (CL, dyn) were determined at constant tidal volume and at ventilatory frequencies ranging from 5 to 45 min-1 by an alveolar capsule technique. Halothane decreased RL at each breathing frequency by causing significant decreases in both Raw and Rti but did not change the relative contribution of Rti to RL at any frequency. Halothane increased CL,dyn at each breathing frequency, although there was little change in the static pressure-volume relationship. The administration of isoproterenol both airway and tissue components of RL; it may act by relaxing the contractile elements in the lung. Both components must be considered when the effects of volatile anesthetics on RL are interpreted. [less ▲] Detailed reference viewed: 10 (0 ULg) Ventilatory effects of continuous epidural infusion of fentanyl.; Brichant, Jean-François ; et alin Anesthesia and Analgesia (1988), 67(10), 971-5 The effects of a continuous epidural administration of fentanyl on pain and on ventilation were studied in eight patients scheduled for orthopedic surgery of the knee. In each subject, epidural fentanyl ... [more ▼] The effects of a continuous epidural administration of fentanyl on pain and on ventilation were studied in eight patients scheduled for orthopedic surgery of the knee. In each subject, epidural fentanyl was given by a bolus dose of 1 microgram.kg-1, followed by a continuous infusion of 1 microgram.kg-1.h-1 over 18 hours. Ventilatory measurements were performed during quiet breathing and during CO2 stimulation tests before surgery. After surgery measurements were made before epidural administration of fentanyl; 1, 2, 5, 18 hours after the start of epidural fentanyl infusion; and 6 hours after its discontinuation. Adequate pain relief was achieved in all patients during fentanyl administration. No significant change in ventilation was noted during quiet breathing. The slope of the ventilatory response to CO2 (VE/PaCO2) decreased significantly from 1.46 +/- 0.2 to 0.75 +/- 0.1 L.min-1.mm Hg-1 (mean +/- SEM; P less than 0.05) one hour after the onset of fentanyl administration, and remained stable throughout the infusion. Eighteen hours after the onset of epidural fentanyl infusion, VE/PaCO2 was still 0.76 +/- 0.14 L.min-1.mm Hg-1. At the end of fentanyl administration, plasma fentanyl levels measured in six patients had progressively increased from 0.42 +/- 0.02 ng.ml one hour after the onset of the infusion to 1.54 +/- 0.19 ng.ml at the end of the infusion. These results suggest that a continuous epidural administration of fentanyl is a technique of analgesia that can provide adequate pain relief but which is associated with ventilatory depression. However, with the doses used in this study, the ventilatory depression remained moderate and of no demonstrable clinical consequence. [less ▲] Detailed reference viewed: 33 (0 ULg) Actions of enflurane, isoflurane, vecuronium, atracurium, and pancuronium on pulmonary resistance in dogs.; ; et al in Anesthesiology (1988), 69(5), 688-95 The effects of enflurane, isoflurane, vecuronium, atracurium, and pancuronium on pulmonary resistance and heart rate were studied in 30 vagotomized dogs lying supine and anesthetized with chloralose ... [more ▼] The effects of enflurane, isoflurane, vecuronium, atracurium, and pancuronium on pulmonary resistance and heart rate were studied in 30 vagotomized dogs lying supine and anesthetized with chloralose-urethane. None of the five drugs affected pulmonary resistance when the airway was unstimulated. Enflurane and isoflurane significantly attenuated the increase in pulmonary resistance induced by electrical stimulation of the vagus nerves. This effect was dose-dependent and similar for both anesthetics at equivalent multiples of their minimum alveolar concentration. Atracurium significantly (P less than 0.05) enhanced the increase in pulmonary resistance induced by vagus nerve stimulation; vecuronium had no significant effect. Pancuronium, up to a cumulative dose of 0.14 mg/kg, also significantly (P less than 0.05) enhanced the increase in pulmonary resistance induced by vagus nerve stimulation; but this effect was reversed by further increasing the dose. Pancuronium also attenuated the cardiodecelerator response to vagus nerve stimulation in a dose-dependent fashion. The underlying mechanisms for the attenuation of responses to vagus nerve stimulation by enflurane or isoflurane or for the increase in response with atracurium are unknown. Pancuronium at lower doses increases the response most likely by blocking prejunctional muscarinic receptors (M2) that physiologically inhibit vagally mediated increases in pulmonary resistance. [less ▲] Detailed reference viewed: 35 (0 ULg) Exploration électromyographique du diaphragme après sternotomie pour chirurgie de revascularisation myocardique; ; Brichant, Jean-François et alin Acta Belgica. Medica Physica (1988), 11 Detailed reference viewed: 27 (0 ULg) Monitorage des fractions inspirées et alvéolaires; Brichant, Jean-François ![]() in Anesthésie par inhalation (1987) Detailed reference viewed: 2 (0 ULg) Signes cliniques de l'anesthésie par inhalationBrichant, Jean-François ; in Anesthésie par inhalation (1987) Detailed reference viewed: 10 (0 ULg) Monitorage de la ventilation assistée; Brichant, Jean-François ![]() in La ventilation artificielle (1987) Detailed reference viewed: 19 (2 ULg) Effets respiratoires de l'obésité: application à la ventilation artificielleBrichant, Jean-François ![]() in Actualités en Anesthésie-Réanimation (1987) Detailed reference viewed: 11 (0 ULg) Effects of high-frequency jet ventilation on arterial baroreflex regulation of heart rate.; ; Brichant, Jean-François et alin Journal of Applied Physiology (Bethesda, Md. : 1985) (1987), 63(6), 2216-22 Fifteen anesthetized mechanically ventilated patients recovering from multiple trauma were studied to compare the effects of high-frequency jet ventilation (HFJV) and continuous positive-pressure ... [more ▼] Fifteen anesthetized mechanically ventilated patients recovering from multiple trauma were studied to compare the effects of high-frequency jet ventilation (HFJV) and continuous positive-pressure ventilation (CPPV) on arterial baroreflex regulation of heart rate. Systolic arterial pressure and right atrial pressure were measured using indwelling catheters. Electrocardiogram (ECG) and mean airway pressure were continuously monitored. Lung volumes were measured using two linear differential transformers mounted on thoracic and abdominal belts. Baroreflex testing was performed by sequential intravenous bolus injections of phenylephrine (200 micrograms) and nitroglycerin (200 micrograms) to raise or lower systolic arterial pressure by 20-30 Torr. Baroreflex regulation of heart rate was expressed as the slope of the regression line between R-R interval of the ECG and systolic arterial pressure. In each mode of ventilation the ventilatory settings were chosen to control mean airway pressure and arterial PCO2 (PaCO2). In HFJV a tidal volume of 159 +/- 61 ml was administered at a frequency of 320 +/- 104 breaths/min, whereas in CPPV a tidal volume of 702 +/- 201 ml was administered at a frequency of 13 +/- 2 breaths/min. Control values of systolic arterial pressure, R-R interval, mean pulmonary volume above apneic functional residual capacity, end-expiratory pulmonary volume, right atrial pressure, mean airway pressure, PaCO2, pH, PaO2, and temperature before injection of phenylephrine or nitroglycerin were comparable in HFJV and CPPV. Baroreflex regulation of heart rate after nitroglycerin injection was significantly higher in HFJV (4.1 +/- 2.8 ms/Torr) than in CPPV (1.96 +/- 1.23 ms/Torr).(ABSTRACT TRUNCATED AT 250 WORDS) [less ▲] Detailed reference viewed: 24 (0 ULg) Electromyographic examination of the human diaphragm using fixed electrodes; ; Brichant, Jean-François et alin Archives Internationales de Physiologie et de Biochimie (1987), 95 Detailed reference viewed: 4 (0 ULg) Mesure de la pression artérielle par voie non sanglante; ; Brichant, Jean-François et alin La sécurité en anesthésie (1987) Detailed reference viewed: 11 (0 ULg) Anesthésie et risque opératoire chez les insuffisants respiratoires chroniques; Brichant, Jean-François ![]() in Collections d'anesthésie et réanimation (1987) Detailed reference viewed: 11 (0 ULg) Effects respiratoires de l'anesthésie et de l'analgésie par voie spinaleBrichant, Jean-François ; in Anesthésie loco-régionale (1986) Detailed reference viewed: 9 (0 ULg) Intermittent positive pressure ventilation with either positive end-expiratory pressure or high frequency jet ventilation (HFJV), or HFJV alone in human acute respiratory failure.Brichant, Jean-François ; ; in Anesthesia and Analgesia (1986), 65(11), 1135-42 Continuous Positive Pressure Ventilation (CPPV), High-Frequency Jet Ventilation (HFJV), and a combination of HFJV with Intermittent Positive Pressure Ventilation (CV) were randomly compared in 13 ... [more ▼] Continuous Positive Pressure Ventilation (CPPV), High-Frequency Jet Ventilation (HFJV), and a combination of HFJV with Intermittent Positive Pressure Ventilation (CV) were randomly compared in 13 critically ill patients with severe acute respiratory failure. Ventilatory settings were chosen in order to apply the same mean airway pressure (Paw) during the three modes. Respiratory frequencies were adjusted during CPPV (16 +/- 2 breaths/min) and HFJV (235 +/- 32 breaths/min) to achieve the same level of PaCO2 and were then combined during CV. All patients were heavily sedated during the study and had had peripheral and balloon-tipped pulmonary arterial catheters previously inserted. After a steady state at FIO2 1 in each mode of ventilation, hemodynamic and respiratory parameters were measured. A Paw of 13.8 +/- 2.9 mm Hg was applied to each patient by using a PEEP of 7.4 mm Hg during CPPV; a driving pressure of 2.9 +/- 0.2 bars and an I/E ratio of 0.43 during HFJV; and by combining HFJV, using a driving pressure of 1.2 +/- 0.3 bars with intermittent positive pressure ventilation during CV. There were no significant differences in any of the hemodynamic or respiratory parameters measured, except for a significant decrease in PaCO2 during CV when compared to CPPV or HFJV. We concluded that 1) arterial oxygenation and cardiac output depend mainly on Paw independent of the method used to increase Paw and 2) CV can improve CO2 elimination without increasing Paw.(ABSTRACT TRUNCATED AT 250 WORDS) [less ▲] Detailed reference viewed: 20 (0 ULg) A.L.R. et anticoagulant: choisir le risque; Brichant, Jean-François ![]() in Mise au point en anesthésie-réanimation (1985) Detailed reference viewed: 36 (0 ULg) |
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