Document Detail


Dopamine stabilizes milrinone-induced changes in heart rate and arterial pressure during anaesthesia with isoflurane.
MedLine Citation:
PMID:  12622495     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND OBJECTIVE: Phosphodiesterase-III inhibitors and dobutamine effectively improve cardiac function in patients with cardiac failure, but they are limited by possible hypotensive effects. We tested the hypothesis that dopamine contributes to stabilizing milrinone-induced haemodynamic changes. METHODS: Nine patients undergoing major surgery were anaesthetized using nitrous oxide and oxygen supplemented with isoflurane 1-2%. After baseline haemodynamics were recorded, milrinone (25 or 50 microg kg(-1)) was administered over 10min, followed by a continuous infusion (0.5 microg kg(-1) min(-1). The second set of haemodynamic values was measured 50 min after beginning the continuous infusion of milrinone. Dopamine (4 microg kg(-1) min(-1)) was then administered with milrinone. RESULTS: Milrinone significantly increased the heart rate from 81 +/- 8 to 102 +/- 16beats min(-1), but it decreased the mean arterial pressure from 83 +/- 10 to 66 +/- 10 mmHg and systemic vascular resistance (P < 0.05 for each). The pulmonary capillary wedge pressure, cardiac index and pulmonary vascular resistance did not change significantly. The addition of dopamine to the milrinone infusion significantly decreased the heart rate (94 +/- 12 beats min(-1)) and increased the mean arterial pressure (82 +/- 11 mmHg). Dopamine and milrinone, but not milrinone alone, significantly increased the cardiac index and the rate-pressure product. CONCLUSIONS: The combination regimen of milrinone and dopamine improved cardiac function, and changes in heart rate and mean arterial pressure induced by milrinone were attenuated by dopamine. The results suggest that a combination regimen of milrinone and dopamine rather than milrinone alone should be used to maintain arterial pressure.
Authors:
F Karasawa; T Okuda; M Tsutsui; N Matsuoka; S Yamada; Y Kawatani; T Satoh
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  European journal of anaesthesiology     Volume:  20     ISSN:  0265-0215     ISO Abbreviation:  Eur J Anaesthesiol     Publication Date:  2003 Feb 
Date Detail:
Created Date:  2003-03-07     Completed Date:  2003-12-12     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8411711     Medline TA:  Eur J Anaesthesiol     Country:  England    
Other Details:
Languages:  eng     Pagination:  120-3     Citation Subset:  IM    
Affiliation:
National Defense Medical College, Department of Anaesthesiology, Saitama, Tokorozawa, Japan. karasawa@me.ndmc.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Analysis of Variance
Anesthesia, General*
Anesthetics, Inhalation / therapeutic use*
Blood Pressure / drug effects*
Cardiotonic Agents / pharmacology*
Digestive System Neoplasms / surgery*
Dopamine / pharmacology*
Drug Therapy, Combination
Heart Rate / drug effects*
Hemodynamics / drug effects*
Humans
Isoflurane / therapeutic use*
Male
Milrinone / pharmacology*
Chemical
Reg. No./Substance:
0/Anesthetics, Inhalation; 0/Cardiotonic Agents; 26675-46-7/Isoflurane; 78415-72-2/Milrinone

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


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