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British Journal of Anaesthesia, 1985, Vol. 57, No. 5 461-475
© 1985 The Board of Management and Trustees of the British Journal of Anaesthesia

research-article

ISOFLURANE AS A ROUTINE ANAESTHETIC IN GENERAL SURGICAL PRACTICE

J. F. NUNN, M.D., PH.D., F.R.C.S., F.F.A.R.C.S., F.F.A.R.A.C.S.(HON.)

Division of Anaesthesia, Clinical Research Centre Watford Road, Harrow, Middlesex HA1 3UJ

One hundred and thirty-five consecutive patients (aged 2 months to 95 yr) were anaesthetized with isoflurane for routine surgery in a District General Hospital. No major problem was encountered. One patient in the series developed ventricular extrasystoles (1 min–1), although 22 patients received a mean dose of adrenaline 3.35 µg kg–1. Seventeen patients had pre-existing myocardial ischaemia or angina, but there was no electrocardiographic evidence of ischaemia developing during anaesthesia. There was a mean increase in heart rate of 5 beat min–1 during anaesthesia although the maximum values reached 200 beat min'1 in children, and 150 beat min–1 in adults who received fazadinium and 140 beat min–1 in adults who did not. Supplementary doses of neuromuscular blocking drugs were seldom needed, and never for closure of peritoneum. There was a very low incidence of untoward events during recovery, although two patients early in the series showed delirium, probably as a result of sudden perception of pain following the rapid recovery. The mean half-time of wash-out of alveolar isoflurane (two patients) was 27 s. The mean volume of isoflurane administered per patient was 22 ml of liquid using fresh gas flow rates in the range 6–9 litre min–1.


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