Dexmedetomidine alters the cardiovascular response during infra-renal aortic cross-clamping in sevoflurane-anesthetized dogs.
Some properties of the volatile anesthetics, such as vasodilatation and myocardial depression, combined with the sympathetic inhibition that alpha2-agonists can produce, may determine hemodynamic alterations during aortic surgery. The interaction between dexmedetomidine (DEX), an alpha2-agonist, and sevoflurane during aortic surgery is unknown. We studied the effects of DEX on hemodynamics and systemic oxygenation during aortic cross-clamping (Aox) and unclamping (UAox) in sevoflurane-anesthetized dogs. Twenty dogs were anesthetized with sevoflurane and were randomly assigned to two groups prior to Aox and UAox: control, n = 10, received saline infusion only, and DEX (1 microg x kg(-1) load followed by 1 microg x kg(-1) x h(-1) infusion), n = 10. Hemodynamic and oxygenation variables were measured at baseline, after saline or DEX loading dose, 20 and 40 min after Aox, and 20 and 40 min after UAox. After DEX administration, heart rate, cardiac index (CI) and systemic oxygen transport index (DO(2)I) were lower than in control group. Aox increased mean arterial pressure (MAP) and systemic vascular resistance index (SVRI) in both groups, but the effects were greater with DEX. CI, heart rate, and DO(2)I were lower, while central venous pressure (CVP) and pulmonary artery occlusion pressure were higher in DEX compared to control. After UAox, MAP, CVP and SVRI were maintained higher in DEX in relation to control. We conclude that in sevoflurane-anesthetized dogs DEX alters the cardiovascular response during aortic surgery.
Braz
Leandro G
LG
Department of Anesthesiology, Botucatu Medical School, UNESP, Botucatu - SP, Brazil. lbraz@fmb.unesp.br
Braz
José R Cerqueira
JR
Castiglia
Yara M Machado
YM
Vianna
Pedro T Galvão
PT
Vane
Luiz A
LA
Módolo
Norma S Pinheiro
NS
do Nascimento
Paulo
P
da Silva
André L
AL
Kinsky
Michael P
MP
D000316:Adrenergic alpha-Agonists / Q000008:administration & dosage*; D018685:Anesthetics, Inhalation / Q000008:administration & dosage*; D000818:Animals; D001011:Aorta / Q000503:physiopathology*; D001794:Blood Pressure / Q000187:drug effects; D003250:Constriction; D020927:Dexmedetomidine / Q000008:administration & dosage*; D004285:Dogs; D004347:Drug Interactions; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006439:Hemodynamics / Q000187:drug effects*; D008297:Male; D008738:Methyl Ethers / Q000008:administration & dosage*; D010101:Oxygen Consumption / Q000187:drug effects; D012077:Renal Artery / Q000503:physiopathology; D015424:Reperfusion; D000077149:Sevoflurane; D014655:Vascular Resistance / Q000187:drug effects
D000316:Adrenergic alpha-Agonists; D018685:Anesthetics, Inhalation; D008738:Methyl Ethers; D000077149:Sevoflurane; D020927:Dexmedetomidine