The Effect of Anesthetics on Myocardial Adenine Nucleotides
The major interest in the effect of anesthetics on high-energy phosphates (adenine nucleotides) in the heart stems from the search for the mechanism of the negative inotropic effect of anesthetics and the interest in preserving myocardial energy during cardiac ischemia. Although the number of studies published is rather small, the results when the preparation has been stable are consistent. Anesthetics do not appear to change the concentration of high-energy phosphates in normal hearts. There is some evidence that barbiturates in high concentrations may interfere with myocardial energy synthesis and decrease high-energy phosphates in hypoxic or ischemic hearts and additional evidence that perhaps cardiac depressant anesthetics such as halothane may preserve high-energy phosphates in ischemic hearts. However, much more investigation is necessary in the ischemic heart in order to come to definite conclusions.
KeywordsCreatine Phosphate Negative Inotropic Effect Thoracic Epidural Anesthesia Total Ischemia Ischemic Contracture
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- 2.Cronau LH, Merin RG, De Jong JW: Effect of halothane on glucose utilization in the perfused working rat heart. J Cardiovasc Pharmacol, in press.Google Scholar
- 4.Freedman B, Christian C, Ham D, Everson C, Wechsler A: Isoflurane and myocardial protection. Anesthesiology 59:A25, 1983 (Abstr)Google Scholar
- 8.Kashimoto S, Tanaka Y, Manabe M, Kumazawa T: Comparison of hemodynamic and metabolic effects of fentanyl and morphine in isolated rat heart lung preparations. Hiroshima J Anesth 21:19–25, 1985Google Scholar
- 10.Kashimoto S, Tsuji Y, Miyaji T, Kumazawa T: Effects of fentanyl and fentanyl-diazepam on myocardial metabolism in isolated rat heart lung preparation. Hiroshima J Anesth 22:297–304, 1986Google Scholar
- 13.Merin RG: Myocardial metabolism. In: Kaplan JA, ed: Cardiac anesthesia. Vol 2, Cardiovascular pharmacology. New York: Grune and Stratton, 1983:243–266Google Scholar
- 21.Taegtmeyer H: Carbohydrate interconversions and energy production. Circulation 72, Suppl IV: 1–8, 1985Google Scholar
- 22.Tsuchida H: Experimental study on the effects of thoracic epidural anesthesia on myocardial pH decrease and metabolic change induced by acute coronary artery occlusion. Sapporo Med J 56:143–155, 1987Google Scholar