TY - JOUR
T1 - Anaesthetic modification of regional myocardial functional adjustments during myocardial ischaemia
T2 - Halothane VS fentanyl
AU - Kim, Y. D.
AU - Danchek, M.
AU - Myers, A. K.
AU - Burke, T. A.
AU - Analouei, A.
AU - Miller, D. L.
AU - Moore, S.
AU - Coughlin, Steven Scott
AU - Visner, M. S.
PY - 1992/3
Y1 - 1992/3
N2 - During myocardial ischaemia, functional compensation occurs by non-ischaemic regions of the left ventricle (LV). Anaesthetics may affect compensation by altering contractility, metabolism and perfusion. This was studied in dogs anaesthetized with fentanyl (150 ng kg-1 loading dose and 100 fig kg-1h-1) or 0.75% and 1.5% halothane and subjected to left anterior descending artery (LAD) occlusion. After 15 min of anterior wall ischaemia, cardiac output, mean arterial pressure and LV maximum dP/dt were diminished in the 1.5% halothane but not in the 0.75% halothane or fentanyl groups. In all groups, stroke volume decreased, LV end-diastolic pressure increased and anterior wall function deteriorated (measured as systolic shortening, peak systolic intramyocardial pressure (IMP), regional wall stroke work (RSW) and slope of preload recruitable stroke work curve (Mw)) with ischaemia. Functional changes in the lateral (non-ischaemic) wall were different between groups. Regional function during occlusion in this area improved with fentanyl (mean (SEM) IMP, RSW and Mw increased by 23 (2)%, 37 (3)% and 69 (7)%, respectively), was relatively well-maintained with 0.75% halothane and diminished with 1.5% halothane.
AB - During myocardial ischaemia, functional compensation occurs by non-ischaemic regions of the left ventricle (LV). Anaesthetics may affect compensation by altering contractility, metabolism and perfusion. This was studied in dogs anaesthetized with fentanyl (150 ng kg-1 loading dose and 100 fig kg-1h-1) or 0.75% and 1.5% halothane and subjected to left anterior descending artery (LAD) occlusion. After 15 min of anterior wall ischaemia, cardiac output, mean arterial pressure and LV maximum dP/dt were diminished in the 1.5% halothane but not in the 0.75% halothane or fentanyl groups. In all groups, stroke volume decreased, LV end-diastolic pressure increased and anterior wall function deteriorated (measured as systolic shortening, peak systolic intramyocardial pressure (IMP), regional wall stroke work (RSW) and slope of preload recruitable stroke work curve (Mw)) with ischaemia. Functional changes in the lateral (non-ischaemic) wall were different between groups. Regional function during occlusion in this area improved with fentanyl (mean (SEM) IMP, RSW and Mw increased by 23 (2)%, 37 (3)% and 69 (7)%, respectively), was relatively well-maintained with 0.75% halothane and diminished with 1.5% halothane.
KW - Anaesthesia, volatile: halothane
KW - Analgesics: fentanyl
KW - Heart: regional myocardial ischaemia
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U2 - 10.1093/bja/68.3.286
DO - 10.1093/bja/68.3.286
M3 - Article
C2 - 1547053
AN - SCOPUS:0026581813
SN - 0007-0912
VL - 68
SP - 286
EP - 292
JO - British Journal of Anaesthesia
JF - British Journal of Anaesthesia
IS - 3
ER -