Effects of Halothane, Fentanyl, and Propofol-Fentanyl Anesthesia on Functional Recovery of Stunned Myocardium in Dogs.
10.4097/kjae.1996.31.3.281
- Author:
Kyung Yeon YOO
1
;
Gyoung Yub RHEE
;
In Chae JANG
;
Chang Young JEONG
Author Information
1. Department of Anesthesiology, Chonnam National University, Kwang-Ju, Korea.
- Publication Type:Original Article
- Keywords:
Heart stunned myocardium;
diastolic function;
systolic myocardial function;
Anesthetics;
volatile halothane;
Anesthetic;
intravenous fentanyl;
propofol
- MeSH:
Anesthesia*;
Anesthetics;
Animals;
Arrhythmias, Cardiac;
Coronary Occlusion;
Coronary Vessels;
Dogs*;
Fentanyl*;
Halothane*;
Heart Ventricles;
Incidence;
Ischemia;
Mortality;
Myocardial Stunning*;
Myocardium;
Oxygen;
Propofol;
Relaxation;
Reperfusion;
Stroke;
Ventricular Fibrillation
- From:Korean Journal of Anesthesiology
1996;31(3):281-292
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Stunned myocardium may be mediated by intracellular Ca2+ overloading or oxygen derived-free radicals. Halothane and propofol have been shown to block Ca2+ channels. Propofol is also known to have antioxidant properties. The present study was aimed to investigate the effects of anesthetics on recovery of postischemic, reperfused myocardium in open-chest dogs. Incidence of ventricular arrhythmia upon ischemia and reperfusion was also determined. METHODS: Forty dogs were subjected to 15 min occlusion of left anterior descending coronary artery (LAD) followed by 3 hr reperfusion during halothane (n=10), fentanyl (n=12), or propofol plus fentanyl (n=11) anesthesia. Regional contractile function was assessed using percent systolic shortening (%SS), the preload recruitable stroke work slope (Mw), and peak systolic intramyocardial pressure (IMPs). Diastolic function was evaluated using time constant for isovolumic intramyocardial pressure decline of left ventricle (IMP-tau) and percent post-systolic shortening (%PSS). RESULTS: %SS in the halothane, fentanyl, and propofol-fentanyl groups was similar at 3 hours of reperfusion (58%, 60%, and 55% of baseline value, respectively). Moreover, Mw recovered to the baseline values in the early reperfusion period in all three groups. However, IMP-tau was significantly prolonged in the halothane group throughout the 3 hour reperfusion period, whereas it remained unchanged in the fentanyl and propofol-fentanyl groups. Coronary occlusion was associated with 9, 33, and 0% mortality rate due to ventricular fibrillation upon ischemia and reperfusion in the halothane, fentanyl, and propofol-fentanyl groups, respectively. CONCLUSION: These findings indicate that halothane, but not fentanyl and propofol- fentanyl, impairs myocardial relaxation, while recovery pattern of contractile function do not differ among three groups, and that halothane and propofol reduce reperfusion arrhythmia in the canine model of myocardial stunning.
