Anaesthetic modification of regional myocardial functional adjustments during myocardial ischaemia: halothane vs fentanyl.
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 micrograms kg-1 loading dose and 100 micrograms kg-1 h-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.
Kim
Y D
YD
Department of Anesthesia, Georgetown University Medical Center, Washington, DC 20007.
Danchek
M
M
Myers
A K
AK
Burke
T A
TA
Analouei
A
A
Miller
D L
DL
Moore
S
S
Coughlin
S
S
Visner
M S
MS
D000769:Anesthesia, Inhalation; D000771:Anesthesia, Intravenous; D000818:Animals; D003327:Coronary Disease / Q000503:physiopathology*; D004285:Dogs; D005260:Female; D005283:Fentanyl / Q000494:pharmacology*; D006221:Halothane / Q000494:pharmacology*; D006321:Heart / Q000187:drug effects*; D006439:Hemodynamics / Q000187:drug effects; D008297:Male; D016277:Ventricular Function, Left / Q000187:drug effects*
D005283:Fentanyl; D006221:Halothane