Document Detail


Comparison of hemodynamic responses to isoproterenol infusion and surgical stress in patients given cardioselective and noncardioselective beta-adrenergic antagonists.
MedLine Citation:
PMID:  2886078     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Recent studies have demonstrated the presence of physiologically active beta 2 receptors in the myocardium. We hypothesized that activation of cardiac beta 2 receptors by endogenously released epinephrine and norepinephrine during surgical stress would add to the positive chronotropic response mediated by beta 1 stimulation. Twenty patients scheduled for coronary artery bypass grafting were studied. Ten patients received a beta 1-selective antagonist (atenolol, 6; metoprolol, 4) and ten patients received a nonselective beta 1 and beta 2 antagonist (propranolol) preoperatively. An isoproterenol dose-heart rate response test was performed. After stabilization, general anesthesia was induced followed by tracheal intubation and surgery. Hemodynamic data were recorded before induction, 1 min after induction, 5 min after intubation, 1 min before and after skin incision, 1 min before and after sternotomy. The ten patients on cardioselective beta-blocker drugs had significantly greater increases in heart rate during isoproterenol administration than did the non-cardioselectively blocked group of patients. Heart rate responses to tracheal intubation and surgical stress were not significantly different between the two groups at any point. We conclude that changes in heart rate during perioperative stress are primarily mediated through activation of beta 1 receptors in the myocardium and that patients on either cardioselective or noncardioselective beta-blockers have similar protection to adrenergic-mediated stressful hemodynamic events.
Authors:
N de Bruijn; J G Reves; N Croughwell; K Knopes
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Anesthesia and analgesia     Volume:  66     ISSN:  0003-2999     ISO Abbreviation:  Anesth. Analg.     Publication Date:  1987 Jul 
Date Detail:
Created Date:  1987-08-07     Completed Date:  1987-08-07     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  1310650     Medline TA:  Anesth Analg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  637-42     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Adrenergic beta-Antagonists / therapeutic use*
Anesthesia, General
Atenolol / therapeutic use
Coronary Artery Bypass
Dose-Response Relationship, Drug
Drug Evaluation
Heart / drug effects
Heart Rate / drug effects
Hemodynamics / drug effects*
Humans
Isoproterenol / therapeutic use*
Metoprolol / therapeutic use
Propranolol / therapeutic use
Receptors, Adrenergic, beta / drug effects
Stimulation, Chemical
Stress, Physiological / physiopathology*
Time Factors
Chemical
Reg. No./Substance:
0/Adrenergic beta-Antagonists; 0/Receptors, Adrenergic, beta; 29122-68-7/Atenolol; 37350-58-6/Metoprolol; 525-66-6/Propranolol; 7683-59-2/Isoproterenol

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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