Cardiodynamic effects of propofol in comparison with thiopental: assessment with a transesophageal echocardiographic approach.
In 40 patients, the cardiovascular effects of low- and high-dose propofol anesthesia (single bolus of 1.5 mg/kg in group A, 2.5 mg/kg in group C) were examined and compared with those of low- and high-dose thiopental (4 mg/kg in group B, 6.5 mg/kg in group D) (n = 10 patients per group). After induction of anesthesia with etomidate, all patients were ventilated with 70% nitrous oxide in oxygen. Peripheral arterial systolic blood pressure (SAP) and transesophageal echocardiographic short-axis measurements were used to calculate the end-systolic pressure-volume relationship (E) as an index of global myocardial contractility. In all groups SAP decreased significantly below baseline levels for the duration of the measurements (15 min after drug administration), except for the lower dose of thiopental, where SAP returned to baseline values within 10 min. Propofol at a dose of 1.5 mg/kg significantly decreased cardiac output (CO) (from 5.1 +/- 0.25 [mean +/- SEM] to 4.2 +/- 0.23 L/min), stroke volume (SV) (from 64 +/- 3 to 56 +/- 3.6 mL), and the slope of E (from 71 +/- 3.5 to 65 +/- 4.2 mm Hg/mL) until 4 min after drug administration. The higher dose of propofol significantly decreased CO (from 5.1 +/- 0.29 to 4.1 +/- 0.26 L/min), SV (from 64 +/- 3 to 52 +/- 4.6 mL), and the slope of E (from 71 +/- 3.6 to 62 +/- 3.7 mm Hg/mL) until 10 min after drug administration.(ABSTRACT TRUNCATED AT 250 WORDS)
Mulier
J P
JP
Department of Anesthesiology, University Hospitals, Katholieke Universiteit Leuven, Belgium.
Wouters
P F
PF
Van Aken
H
H
Vermaut
G
G
Vandermeersch
E
E
D000328:Adult; D000368:Aged; D003864:Depression, Chemical; D004452:Echocardiography / Q000379:methods; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D007275:Injections, Intravenous; D008875:Middle Aged; D009200:Myocardial Contraction / Q000187:drug effects*; D015742:Propofol / Q000008:administration & dosage / Q000494:pharmacology*; D013874:Thiopental / Q000008:administration & dosage / Q000494:pharmacology*
D013874:Thiopental; D015742:Propofol