Summary and Conclusions
Forty-one aeute experiments were done on 11 mongrel dogs after 25 minutes of 1 per cent methoxyflurane-oxygen anaesthesia to determine the severity of cardiac arrhythmias produced by an epinephrine challenge and to evaluate the efficacy of SA 97 (an antihistaminic) as a protectant. Perphenazine and hydroxyzine were also used as a comparison with SA 97. Pulmonary ventilation was augmented during anaesthesia to eliminate hypoxia and hypercarbia during the experiments. The doses selected for each agent were such (that severe hypotension would not be expected to occur prior to the epinephrine challenge.
The arrhythmias provoked by an epinephrine challenge during methoxyflurane anaesthesia were less severe than those seen in similar experiments with trichlorethylene, cyclopropane, and halothane, but were similar, to those during anaesthesia with halothane-ether azeotrope and light chloroform.
Perphenazine in a dose of 0.25 mg./kg. was more effective than hydroxyzine (1 mg.Ag.) and SA 97 (1 mg./kg.) in reducing cardiac arrhythmias produced by an epinephrine challenge. However, none of the drugs completely eliminated serious ventricular arrhythmias. Therefore; epinephrine should not be used during anaesthesia with methoxyflurane, unless a small amount is injected sub-cutaneously in a very dilute solution ( less than 1:200,000 )
Résumé
Après 25 minutes d’anesthésie avec 1 pour cent de méthoxyflurane et oxygène, chez 11 chiens mongrel, nous avons pratiqué 41 expériences pour déterminer la fréquence des arythmies cardiaques produites par l’administration d’épinéphrine et, en même temps, le degré de protection procurée par le SA 97 (un antihistaminique ). Nous avons également employé la perphénazine et l’hydroxyzine pour en comparer les effets avec ceux du SA 97. Au cours des anaesthésies, nous avons augmenté les échanges respiratoires pour éliminer toute hypoxie ou toute hypercarbie au cours des expériences. Pour chacun de ces agents, nous avions déterminé une dose telle qu’il n’y avait pas lieu de craindre l’apparition d’une hypotension marquée avant l’injection d’épinéphrine.
Les arythmies provoquées par l’injection d’épinéphrine durant l’anesthésie au méthoxyflurane ont été moins marquées que celles observées au cours d’expériences semblables avec lé trichloréthylène, lé cyclopropane et l’halothane, mais elles ressemblaient à celles que nous avons observées au cours de l’anesthésie halothane-éther azéotropique et l’anesthésie légère au chloroforme.
La perphénazine à raison de 0.25 mg./kg. s’est avérée plus efficace que l’hydroxyzine (1 mg./kg.) et le SA 97 (1 mg./kg.) pour diminuer les arythmies cardiaques occasionnées par l’injection d’épinéphrine.
Toutefois, aucun de ces médicaments n’a réussi à faire disparaître complètement l’arythmie ventriculaire importante. En conséquence, au cours de l’anesthésie au methoxyflurane, il serait déconseillé de faire usage d’épméphrine chez le malade, à moins qu’il ne s’agisse que d’une petite quantité administrée en injection sous-cutanée et en solution très diluée (moins de 1:200,000).
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References
Artusio, J. F.;Van Poznak, A.;Hunt, R. E.;Tiers, F. M.; &Alexander, M. Clinical Evaluation of Methoxyflurane in Man. ArJesthesiology21: 512 (1960).
Wasmuth, C. E.et al. Methoxyfluranel-New Anesthetic Agent-Clinical Evaluation Based on 206 cases. Cleveland Clin. Quart.27: 174 (1960).
Dobkin, A. B., &Fedoruk, S. Comparison of the Cardiovascular Respiratory and Metabolic Effects of Methoxyflurane and Halothane in Dogs. Anesthesiology22: 355 (1961).
Bamforth, B. J.;Siebecker, K. L.;Kraemer, R.; &Orth, O. S. Effect of Epinephrine on the Dog Heart During Methoxyflurane Anesthesia. Anesthesiology22: 169 (1961).
Wheeler, N. Abbott Laboratories. Personal communication.
Drill, V. A., Pharmacology in Medicine. 2nd. ed. McGraw-Hill ( 1958). Pp. 626–32.
Dobkin, A. B., &Purkin, N. The Effect of Perphénazine on Epinephrine Induced Cardiac Arrhythmias in Dogs. I. Anaesthesia with Fluothane and thé Fluothane-Ether Azeotrope. Canad. Anaesth. Soc. J.6: 243 (1959).
Dobkin, A. B.;Donaldson, H.; &Purkin, N. The Effect of Perphenazine on Epinephrine-Induced Cardiac Arrhythmias in Dogs. 2. Anaesthesia with Cyclopropane Chloroform and Trichlorethylene. Canad Anaesth. Soc. J.6: 251 (1959).
Hutcheon, D. E.;Scriabine, A.; &Morris, D. L. Cardiovascular Action of Hydrojxy- zine. J. Pharmacol. & Exper. Therap.118: 451 (1956).
Burrell, Z. L.;Gittinger, W. C.; &Martinez, A. Treatment of Cardiac Arrhythmias with Hydroxyzine. Am. J. Cardiol.1: 624 (1958).
Virtue, R. W.;Caronna, L. J.; &Takaoka, K. The Respiratory Pattern and Cardiac Output. Brit. J. Anaesth.33: 77 (1961).
Dobkin, A. B. The Takaoka Respirator for Automatic Ventilation of the Lungs. Canad. Anaesth. Soc. J.8: 556 (1961).
Dobkin, A. B.;Gilbert, R. G. B.; &Melville, K. I. Chlorpromazine: Review and Investigation as a Premedicant in Anesthesia. Anesthesiology17: 135 (1956).
Dobkin, A. B. The Effect of Anaesthetic Agents on the Cardiovascular System: A Review. Canad. Anaesth. Soc. J.7: 317 (1960).
Miller, F. A.;Brown, E. B.;Buckley, J.;Van Bergen, F. H.; &Varjco, R. L. Reippiratory Acidosis: Its Relationship to Cardiac Function and Other Physiologic Mechanisms. Surgery32: 171 (1952).
Orth, O. S.;Leigh, M. D.;Mellish, C. H.; &Stutjzman, J. W. Action of Sympathomimetic Amines in Cyclopropane and Chloroform Anaesthesia. J. Pharmacol. & Exppr. Therap.67: 1 (1939).
Meek, W. J. Some Cardiac Effects of Inhalent Anesthetic? and the Sympathomimetic Amines. Harvey Lect.36: 188 (1941).,
Dobkin, A. B.;Deummond, K.; &Purkin, N. Anaesthesia jvvith the A^eotropic Mixture of Halothane and Diethjl Ether. Brit. J. Anaesth.31: 53 (1959).
Dobkin, A. B. Efficacy of Ataractic Drugs in Clinical Anaestliesia. Canad. Anaesth. Soc.J.5: 176 (1958).
Arora, R. B. Antiarrhythmics: Quinidine-like Activity of Some Ataractic Agents. J. Pharmacol. & Exper. Therap.124: 53 (1958).
Levitan, B. A., &Scott, J. H. Inhibition of Chlo;rofonjn-Adrenalin Fibrillation by Antihistamiries. Canad. M.A.J.61: 303 (1949).
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From the Department of Anesthesiology, Upstate Medical Center, Syracuse, New York.
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Dobkin, A.B. The effect of sa 97, perphenazine, and hydroxyzine on epinephrine-induced cardiac arrhythmias during methoxyflurane anaesthesia in dogs. Can. Anaes. Soc. J. 9, 36–41 (1962). https://doi.org/10.1007/BF03021236
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DOI: https://doi.org/10.1007/BF03021236