Abstract
Prostaglandin E1-induced hypotension (25% reduction from the preadministration level in mean arterial pressure) was applied to thirteen patients. Eight patients among them were operated in the supine position (group I) and other five in the prone position (group II). The maintenance dose of PGE1 was considerably lower in group II than in group I (0.067 μg·kg−1·min−1 vs. 0.119 μg·kg−1·min−1). In group I, there was a significant increase in CI, with a significant decrease in SVRI and PVRI during PGEI-induced hypotension. Such a high dose of PGE1 (0.119 μg·kg−1·min−1) was considered to have a direct dilating action on the systemic resistance bed as well as on the pulmonary vasculature. It was considered that the suppression of hypoxic pulmonary vasoconstriction could be a mechanism to increase venous admixture during PGE1-induced hypotension. In group II, there was no significant increase in CI, and no significant decrease in SVRI and PVRI. PGE1-induced hypotension can be safely applied to the anesthetized patients, but we should be careful to apply it to the patients in the prone position, because lower dose of PGE1 can induce severe hypotension, which is not accompanied by the increase in CI as occures in the patients in the supine position.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
D’Ambra MN, LaRaia PJ, Philbin DM: Prostadlandin E1 — a new therapy for refractory right heart failure and pulmonary hypertension after mitral valve replacement. J Thorac Cardiovasc Surg 89:567–572, 1985
Naeije R, Melot C, Mols P, Hallemans R: Reduction in pulmonary hypertension by prostaglandin E1 in decompensated chronic obstructive pulmonary disease. Am Rev Respir Dis 125:1–5, 1982
Awan NA, Evenson MK, Needham KE: Cardiocirculatory and myocardial energetic effects of prostaglandin E1 in severe left ventricular failure due to chronic coronary heart disease. Am Heart J 102:703–709, 1981
Popat KD, Pitt B: Hemodynamic effects of prostaglandin E1 infusion in patients with acute myocardial infarction and left ventricular failure. Am Heart J 103:485489, 1982
Wear EK, Reeves JT, Grover RF: Prostaglandin E1 inhibits the pulmonary vascular pressor response to hypoxia and prostaglandin F2α. Prostaglandins 10:623–631, 1975
Holcroft JW, Vassar MJ, Weber CJ: Prostaglandin E1 and survival in patients with the adult respiratory distress syndrome. Ann Surg 203:371–378, 1986
Bishop MJ, Cheney FW: Effects of pulmonary blood flow and mixed venous O2 tention on gas exchange in dogs. Anesthesiology 58: 130–135, 1983
Cheney FW, Colley PS: The effect of cardiac output on arterial blood oxygenation. Anesthesiology 52:496–503, 1980
Cathely PA, Lear S, Cottrell JE, Lear E: Intrapulmonary shunting during induced hypotention. Anesth Analg 61:231–235, 1982
Buffington CW, Davis KB, spie S, Pettinger M: Prevalence of Steal-prone coronary Anatomy in patients with coronary artery disease: an analysis of the coronary artery surgery study resistry. Anesthesiology 69:721–727,1988
Becker LC: Condition for vasodilator-induced coronary steal in experimental myocardial ischemia. Circulation 57:1103–1110, 1978
Relton JES, Hall JE: An operational frame for spinal fusion. J Bone Joint Surg 49B:327–332, 1967
Relton JES, Conn AW: Anaesthesia for the surgical Correction of scoliosis by the Harrington method in children. Can Anaesth Soc J10:603–615, 1963
Author information
Authors and Affiliations
About this article
Cite this article
Hirose, M., Yoda, K., Sakai, K. et al. Comparative study on the cardio-respiratory change during prostaglandin E1-induced hypotension in the patients in the supine and prone position. J Anesth 5, 30–35 (1991). https://doi.org/10.1007/s0054010050030
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/s0054010050030