[Effects of deliberate hypotension on the ischemic heart during isoflurane anesthesia--a comparison of prostaglandin E1 and sodium nitroprusside].
The effects of hypotension induced by prostaglandin E1 (PGE1) or sodium nitroprusside (SNP) on regional myocardial function and metabolism were studied in a canine heart with coronary artery stenosis. Ultrasonic dimension technique was used to assess left ventricular performance. Fourteen open-chest mongrel dogs were anesthetized with isoflurane and mean aortic pressure was maintained at approximately 80 mmHg. The left circumflex coronary artery blood flow was reduced by 40% using a screw flow regulator without affecting global and regional myocardial function. The severity of stenosis was considered almost critical. PGE1 (n = 7) or SNP (n = 7) was administered to reduce mean aortic pressure to 50 mmHg. There were no significant differences between PGE1 and SNP regarding their effect on systemic hemodynamics. Nevertheless SNP decreased percent segment shortening in the stenosed area from the pre-hypotension value more significantly than PGE1 (55.0 +/- 10.8% versus 24.2 +/- 7.3%). This suggests that regional myocardial ischemia is more deteriorated during SNP-induced hypotension. It seems that PGE1-induced hypotension is safer when it is applied to patients with coronary artery disease.
Kimura
H
H
Department of Anesthesiology, University of Tokushima School of Medicine.
Kohyama
A
A
D000527:Alprostadil; D000769:Anesthesia, Inhalation; D000818:Animals; D003326:Coronary Circulation; D003327:Coronary Disease / Q000378:metabolism / Q000503:physiopathology*; D004285:Dogs; D006439:Hemodynamics; D007023:Hypotension, Controlled; D007530:Isoflurane; D009200:Myocardial Contraction; D009599:Nitroprusside
D009599:Nitroprusside; D007530:Isoflurane; D000527:Alprostadil