Hemodynamic and cardiodynamic effects of propofol and etomidate: negative inotropic properties of propofol.
The hemodynamic effects of an induction dose of propofol, 2.5 mg/kg, or etomidate, 0.3 mg/kg, were studied in eight dogs. In addition, cardiodynamic changes were measured using a left ventricular catheter and needle force probes. Propofol was associated with significant decreases in systolic (19.9%) and diastolic (25.3%) arterial pressures associated with a 17.3% decrease in cardiac output (CO) and a 11.6% reduction in systemic vascular resistance (SVR) without change in pulmonary capillary wedge pressure (PCWP). These changes were most pronounced 1 min after the injection of propofol. At 5 and 10 min after the administration of propofol, heart rate (HR) decreased significantly. Minimal changes in hemodynamics were observed with etomidate. Propofol lowered systolic left ventricular pressure (LVPsys) by 17.6%. Signals generated by the force probes in the left ventricular myocardium showed a significant reduction (16.3%) in left ventricular force (LVF) and a decrease in early systolic rates of increase in force (dF/dt max) by 23.5% associated with propofol. In the presence of an unchanged preload, an unchanged HR, and a decreased SVR, the reduction in CO suggests that propofol has a negative inotropic effect. This negative inotropic effect was confirmed by a reduction in LVF and dF/dt max.
Brüssel
T
T
Klinik und Poliklinik für Anaesthesiologie und operative Intensivmedizin der Westfälischen Wilhelms-Universität, Münster, West Germany.
Theissen
J L
JL
Vigfusson
G
G
Lunkenheimer
P P
PP
Van Aken
H
H
Lawin
P
P
D000777:Anesthetics / Q000494:pharmacology*; D000818:Animals; D004285:Dogs; D005045:Etomidate / Q000494:pharmacology*; D005260:Female; D006439:Hemodynamics / Q000187:drug effects*; D007275:Injections, Intravenous; D008297:Male; D009200:Myocardial Contraction / Q000187:drug effects*; D010636:Phenols / Q000494:pharmacology*; D015742:Propofol
D000777:Anesthetics; D010636:Phenols; D015742:Propofol; D005045:Etomidate