| Influence of anesthesia on the threshold of pacing-induced ischemia. | |
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MedLine Citation:
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PMID: 1734776 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Increased myocardial oxygen demand, induced by increased heart rate, may cause myocardial ischemia in the presence of significant coronary artery disease. Alterations in anesthetic depth or technique might put at risk or protect myocardium with compromised blood flow. In 20 dogs with critical left anterior descending coronary artery (LAD) stenosis, atrial pacing rates from 100 to 160 beats/min were achieved, with end-tidal halothane 0.7% (LowH) and 1.1% (HighH), end-tidal isoflurane 1.1% (LowI) and 1.5% (HighI), as well as with continuous fentanyl plus midazolam (FM) infusion anesthesia. Despite significantly different mean arterial and coronary perfusion pressures, rate-pressure product, and left ventricular dP/dtmax, the pacing rate at which systolic shortening decreased below the lower limit of the physiologic response, indicating regional dysfunction, was the same in all investigated anesthesia conditions (LowH: 127 +/- 4 beats/min; HighH: 128 +/- 5 beats/min; LowI: 125 +/- 4 beats/min; HighI: 122 +/- 5 beats/min; FM: 124 +/- 4 beats/min [mean +/- SEM], P greater than 0.05). None of the investigated anesthesia conditions either increased ischemia tolerance or showed a detrimental effect on myocardium with compromised coronary blood flow. |
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Authors:
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D R Spahn; L R Smith; C D Veronee; W C Hu; R L McRae; B J Leone |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Anesthesia and analgesia Volume: 74 ISSN: 0003-2999 ISO Abbreviation: Anesth. Analg. Publication Date: 1992 Jan |
Date Detail:
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Created Date: 1992-03-03 Completed Date: 1992-03-03 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 1310650 Medline TA: Anesth Analg Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 14-25 Citation Subset: AIM; IM |
Affiliation:
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Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina 27710. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Animals Cardiac Pacing, Artificial Coronary Circulation / drug effects Coronary Disease / physiopathology* Dogs Halothane / pharmacology* Heart / drug effects* Hemodynamics / drug effects Isoflurane / pharmacology* |
| Chemical | |
Reg. No./Substance:
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151-67-7/Halothane; 26675-46-7/Isoflurane |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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