title: Persistent depression of contractility and vasodilation with propofol but not with sevoflurane or desflurane in rabbits.
abstract: BACKGROUND
  Propofol, sevoflurane, and desflurane may cause hemodynamic compromise during anesthesia and critical care management. The aim of the study was to compare these anesthetics during increased dose and recovery to maintenance level.
  
  
  METHODS
  Anesthetized, open-chest New Zealand White rabbits were used to acquire dose-response curves with sevoflurane, desflurane, and propofol, followed by reduction to baseline infusion. Simultaneous high-fidelity left ventricular pressure and volume data were acquired during caval occlusion with a dual-field conductance catheter inserted via an apical stab. The preload recruitable stroke work and the end-diastolic pressure-volume relationship were used as the primary measures of contractility and diastolic function.
  
  
  RESULTS
  The time-matched controls were stable over time. Propofol and desflurane but not sevoflurane caused dose-dependent reductions in myocardial contractility, although sevoflurane reduced contractility more at 1 minimal alveolar concentration. All anesthetics reduced mean arterial pressure, and significant recovery occurred for sevoflurane and desflurane but not for propofol. The end-diastolic pressure-volume relationship was increased by sevoflurane. Ejection fraction decreased with sevoflurane only. All anesthetics caused dose-dependent vasodilation, with recovery for desflurane and sevoflurane but not propofol. Heart rate was decreased with propofol without significant recovery. Propofol plasma concentrations remained elevated after dose return to baseline infusion rate, suggestive of distribution compartment saturation.
  
  
  CONCLUSIONS
  All three anesthetics caused dose-dependent decreases in cardiovascular function. Recovery of cardiovascular function occurred rapidly with sevoflurane and desflurane, but persistent depression of contractility, vasodilation, mean arterial pressure, and heart rate occurred with propofol during a 30-min recovery period.
authors.affiliation: Anaesthesia and Pain Management Research Unit, Department of Pharmacology, University of Melbourne, Victoria, Australia. colin.royse@unimelb.edu.au
authors.forename: Colin Forbes
authors.initials: CF
authors.lastname: Royse
authors.forename: David F L
authors.initials: DF
authors.lastname: Liew
authors.forename: Christine E
authors.initials: CE
authors.lastname: Wright
authors.forename: Alistair G
authors.initials: AG
authors.lastname: Royse
authors.forename: James A
authors.initials: JA
authors.lastname: Angus
mesh_terms: D018686:Anesthetics, Intravenous; D000818:Animals; D000077335:Desflurane; D004305:Dose-Response Relationship, Drug; D006339:Heart Rate / Q000187:drug effects / Q000502:physiology; D007530:Isoflurane / Q000031:analogs & derivatives; D008738:Methyl Ethers; D009200:Myocardial Contraction / Q000187:drug effects; D015742:Propofol; D011817:Rabbits; D000077149:Sevoflurane; D014661:Vasoconstriction / Q000187:drug effects* / Q000502:physiology; D014664:Vasodilation / Q000187:drug effects* / Q000502:physiology
chemical_list: D018686:Anesthetics, Intravenous; D008738:Methyl Ethers; D000077149:Sevoflurane; D000077335:Desflurane; D007530:Isoflurane; D015742:Propofol