Document Detail

Persistent depression of contractility and vasodilation with propofol but not with sevoflurane or desflurane in rabbits.
MedLine Citation:
PMID:  18156886     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Propofol, sevoflurane, and desflurane may cause hemodynamic compromise during anesthesia and critical care management. The aim of the study was to compare these anesthetics during increased dose and recovery to maintenance level. METHODS: Anesthetized, open-chest New Zealand White rabbits were used to acquire dose-response curves with sevoflurane, desflurane, and propofol, followed by reduction to baseline infusion. Simultaneous high-fidelity left ventricular pressure and volume data were acquired during caval occlusion with a dual-field conductance catheter inserted via an apical stab. The preload recruitable stroke work and the end-diastolic pressure-volume relationship were used as the primary measures of contractility and diastolic function. RESULTS: The time-matched controls were stable over time. Propofol and desflurane but not sevoflurane caused dose-dependent reductions in myocardial contractility, although sevoflurane reduced contractility more at 1 minimal alveolar concentration. All anesthetics reduced mean arterial pressure, and significant recovery occurred for sevoflurane and desflurane but not for propofol. The end-diastolic pressure-volume relationship was increased by sevoflurane. Ejection fraction decreased with sevoflurane only. All anesthetics caused dose-dependent vasodilation, with recovery for desflurane and sevoflurane but not propofol. Heart rate was decreased with propofol without significant recovery. Propofol plasma concentrations remained elevated after dose return to baseline infusion rate, suggestive of distribution compartment saturation. CONCLUSION: All three anesthetics caused dose-dependent decreases in cardiovascular function. Recovery of cardiovascular function occurred rapidly with sevoflurane and desflurane, but persistent depression of contractility, vasodilation, mean arterial pressure, and heart rate occurred with propofol during a 30-min recovery period.
Colin Forbes Royse; David F L Liew; Christine E Wright; Alistair G Royse; James A Angus
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Anesthesiology     Volume:  108     ISSN:  1528-1175     ISO Abbreviation:  Anesthesiology     Publication Date:  2008 Jan 
Date Detail:
Created Date:  2007-12-24     Completed Date:  2008-01-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  1300217     Medline TA:  Anesthesiology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  87-93     Citation Subset:  AIM; IM    
Anaesthesia and Pain Management Research Unit, Department of Pharmacology, University of Melbourne, Victoria, Australia.
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MeSH Terms
Anesthetics, Intravenous*
Dose-Response Relationship, Drug
Heart Rate / drug effects,  physiology
Isoflurane / analogs & derivatives
Methyl Ethers
Myocardial Contraction / drug effects
Vasoconstriction / drug effects*,  physiology
Vasodilation / drug effects*,  physiology
Reg. No./Substance:
0/Anesthetics, Intravenous; 0/Methyl Ethers; 2078-54-8/Propofol; 26675-46-7/Isoflurane; 28523-86-6/sevoflurane; 57041-67-5/desflurane

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