Abstract
Background
Clinical use of high dose beta-blocker therapy is limited by excessive negative inotropic effects. Previous studies suggest that milrinone may be of utility in limiting the inotropic but not the chronotropic effects of beta blockers. We examined the hemodynamic effects of co-administration of a new potent selective beta1 blocker, landiolol, and milrinone in halothane-anesthetized dogs.
Methods
Eighteen adult mongrel dogs were anesthetized with 1.2 MAC halothane. Hemodynamic measurements were made at baseline, 30 min after starting the milrinone (0.5 μg·kg−1·min−1) or normal saline infusion (n = 9 in each), then 30 min after each change in the dose of landiolol infusion. The tested doses of landiolol were 10, 100, and 1000 μg·kg−1·min−1.
Results
Landiolol (≥ = 10 μg·kg−1·min−1) has significant and comparable negative chronotropic effects in both groups of dogs. While it also has significant negative inotropic effects in both groups, such effects are significantly attenuated in the dogs treated with milrinone.
Conclusion
Milrinone is effective to attenuate the negative inotropic effects of landiolol in halothane-anesthetized dogs.
Résumé
Contexte
L’usage clinique de fortes doses thérapeutiques de β-bloquants est limité par des effets inotropes négatifs excessifs. Des études antérieures laissent voir que la milrinone peut limiter les effets inotropes, mais non chronotropes, des β-bloquants. Nous avons vérifié les effets hémodynamiques de la co-administration d’un nouveau β1-bloquant, sélectif et puissant, le landiolol, et de milrinone chez des chiens anesthésiés avec de l’halothane.
Méthode
Dix huit chiens de race commune ont été anesthésiés avec 1,2 CAM d’halothane. Les tests hémodynamiques ont été faits au départ, 30 min après l’administration de milrinone (0,5 μg·kg−1·min−1) ou d’une perfusion de solution saline (n = 9 dans chaque groupe), puis 30 min après chaque changement de dose de landiolol. Les doses test de landiolol ont été de 10, 100 et 1000 μg·kg−1 ·min−1.
Résultats
Le landiolol (≥ = 10 μg·kg−1·min−1) a produit des effets chronotropes négatifs comparables et significatifs chez les deux groupes de chiens. Il a aussi eu des effets inotropes négatifs significatifs chez les deux groupes, mais ces effets sont diminués de façon significative chez les chiens traités avec la milrinone.
Conclusion
La milrinone est efficace pour diminuer les effets inotropes négatifs du landiolol chez des chiens anesthésiés avec de l’halothane.
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Takahashi, S., Fujii, Y., Hoshi, T. et al. Milrinone attenuates the negative inotropic effects of landiolol in halothane-anesthetized dogs. Can J Anesth 50, 830–834 (2003). https://doi.org/10.1007/BF03019382
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DOI: https://doi.org/10.1007/BF03019382