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Effects of sevoflurane on cardiovascular dynamics, coronary circulation and myocardial metabolism in dogs

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Abstract

The effects of 2.5% and 5% of sevoflurane anesthesia on hemodynamics and myocardial metabolism were studied in pentobarbital-pancuronium anesthetized dogs. The interaction between nicardipine and 2.5% sevoflurane was also examined. Sevoflurane produced dose-dependent (P<0.05 toP<0.01) decreases in systolic arterial pressure (SAP), heart rate (HR), cardiac index (CI), left ventricular minute work index (LVMWI), maximum rate of rise of left ventricular pressure (LV dP/dt), the time constant of fall in isovolumic left ventricular pressure (T) and systemic vascular resistance (SVR), whereas stroke volume index (SVI) and left ventricular end-diastolic pressure (LVEDP) remained unchanged. Central venous pressure (CVP) was significantly (P<0.05) increased at 5%. Myocardial oxygen consumption\(M\dot V_{O_2 } \), and myocardial lactate extraction ratio (ML ext) were decreased in a dose-dependent manner (P<0.05). Myocardial oxygen extraction ratio (MO 2 ext) was significantly (P<0.01) decreased at 5%. The ratio of the left ventricular minute work index to myocardial oxygen consumption\(LVMWI/M\dot V_{O_2 } \), i.e., left ventricular efficiency was significantly decreased only at 5% (P<0.05). Coronary sinus blood flow (CSBF) was significantly (P<0.05) decreased only at 2.5% sevoflurane and coronary vascular resistance (CVR) was significantly (P<0.01) decreased only at 5% sevoflurane. The ratio of CSBF to CO (CSBF/CO) showed a tendency to increase as sevoflurane concentrations were increased. Nicardipine (0.01 mg·kg−1) administered intravenously under 2.5% sevoflurane caused significant (P<0.05 toP<0.01) decreases in SAP, HR, LV dP/dt, SVR, and CVR, and increases in CVP, SVI, CI, and CSBF (P<0.05 toP<0.01). CSBF/CO remained unchanged.\(M\dot V_{O_2 } \), MO 2 ext, and ML ext were significantly (P<0.05 toP<0.01) decreased.\(LVMWI/M\dot V_{O_2 } \) showed a tendency to increase. It is concluded that sevoflurane causes a rapidly and easily controlled cardiovascular depression and may not have unfavorable effects on coronary circulation and myocardial metabolism. Nicardipine exerts a synergistic myocardial depressant effect on sevoflurane, in terms of both cardiovascular dynamics and myocardial metabolism.

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Authors and Affiliations

  1. Department of Anesthesiology, Jichi Medical School, 3311-1, Yakushiji, Minamikawachi-machi, 329-04, Tochigiken, Japan

    Satoshi Akazawa, Reiju Shimizu, Haruyuki Kasuda, Kunio Nemoto, Yuriko Yoshizawa & Souzaburou Inoue

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  1. Satoshi Akazawa
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  2. Reiju Shimizu
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  3. Haruyuki Kasuda
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  4. Kunio Nemoto
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  5. Yuriko Yoshizawa
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  6. Souzaburou Inoue
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Akazawa, S., Shimizu, R., Kasuda, H. et al. Effects of sevoflurane on cardiovascular dynamics, coronary circulation and myocardial metabolism in dogs. J Anesth 2, 227–241 (1988). https://doi.org/10.1007/s0054080020227

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  • DOI: https://doi.org/10.1007/s0054080020227

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