Abstract
The antiarrhythmic effect of esmolol, a selective beta1 adrenoreceptor blocker, was evaluated in the presence of epinephrine induced arrhythmias in dogs (n = 6). The arrhythmogenic dose of epinephrine (ADE) during 1.2 MAC halothane in dogs was increased from 3.23 ± 0.25 (mean ± SD) to 30.90 ± 3.56 μg · kg−1 · min−1 (P < 0.001) by the prior administration of esmolol 0.5 μg · kg−1 bolus followed by an infusion at the rate of 150 μg · kg−1 · min−1. Higher esmolol infusion doses of 200 μg · kg−1 · min−1 further increased ADE to 99.0 ± 2.92 μg · kg−1 · min−1 (P < 0.001). After discontinuation of esmolol and during continued halothane anaesthesia, ventricular tachycardia was induced by increasing the infusion rate of the 100 μg · ml−1 solution of epinephrine. In all dogs ventricular tachycardia was restored to sinus rhythm by a bolus dose of esmolol (1 μg · kg−1). We conclude that esmolol pretreatment increases the ADE during halothane anaesthesia in dogs. Our data suggest that esmolol may be useful as an antiarrhythmic agent in the management of epinephrinerelated ventricular arrhythmias during anaesthesia in man.
Résumé
L’effet antiarythmique de l’esmonol, un agent bloqueur sélectif des récepteurs adrénergiques beta1, a été évalué chez des chiens (6) en présence d’arythmies induites par l’épinéphrine. La dose arythmogène d’épinéphrine (ADE) sous 1,2 MAC d’halothane chez les chiens était augmentée de 3,23 ± 0,25 (moyenne ± ET) à 30,90 ± 3,56 μg · kg−1 · min−1 (P < 0,001) suite à l’administration d’une dose d’esmonol de 0,5 μg · kg−1 suivie d’une perfusion à 150 μg · kg−1 · min−1. Des perfusions d’esmonol plus importantes à des doses de 200 μg · kg−1 · min−1 ont augmenté l’ADE à 99,0 ± 2,92 μg · kg−1 · min−1 (P < 0,001). Suite à l’arrêt de l’esmonol et sous anesthésie continue à l’halothane, une tachycardie ventriculaire était provoquée en augmentant la perfusion de la solution d’épinéphrine à 100 μg · ml−1. Chez tous les chiens, la tachycardie ventriculaire faisait place à un rythme sinusal grâce à une dose de bolus de 1 μg · kg−1 d’esmonol. En conclusion, un prétraitement à l’esmonol augmente l’ADE lors d’une anesthésie sous halothane chez les chiens. Nos résultats suggèrent que l’esmonol pourrait être utile en tant qu’agent antiarythmique dans le traitement des arythmies ventriculaires reliées à l’épinéphrine durant l’anesthésie chez l’homme.
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Dimich, I., Lingham, R., Narang, J. et al. Esmolol prevents and suppresses arrhythmias during halothane anaesthesia in dogs. Can J Anaesth 39, 83–86 (1992). https://doi.org/10.1007/BF03008680
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DOI: https://doi.org/10.1007/BF03008680