Acute changes in bladder volume produce minimal cardio-respiratory responses in lightly anesthetised humans.

Abstract

To examine whether changes in bladder volume elicit reflex cardiovascular and respiratory responses in humans under general anesthesia with sevoflurane and nitrous oxide. Fourteen patients free of autonomic disorders were anesthetized with sevoflurane 0.5% and nitrous oxide 60% in oxygen that were approximately equivalent to 0.9 MAC. Warmed saline (6 ml x kg(-1), 37 degrees C) was instilled into the pre-emptied urinary bladder, and then the bladder was kept distended for five minutes. Following the distension, the instilled saline was drained to the pre-instilled volume of the bladder Arterial blood pressure, respiratory flow, and intra-vesicle pressure were continuously measured, and mean arterial pressure, pulse rate, respiratory rate, tidal volume, and minute ventilation were estimated offline from these signals. Bladder emptying produced small decreases in mean blood pressure (from 83.4+/-4.3 to 80.0+/-4.4 mm Hg, mean +/- SE, P = 0.017) and pulse rate (from 72.2+/-2.9 to 69.4+/-2.7 bpm, mean +/- SEM, P = 0.004). Only minimal respiratory reflexes were invoked by the bladder volume changes. In lightly anesthetized humans, the acute changes in bladder volume produce only mild cardiovascular and respiratory responses.