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Are the cardiovascular actions of dopamine altered by isoflurane?
Author(s) -
Raner C.,
Biber B.,
Henriksson B.Å.,
Lundberg J.,
Martner J.,
Winsö O.
Publication year - 1995
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/j.1399-6576.1995.tb04147.x
Subject(s) - medicine , preload , pulmonary artery , isoflurane , pulmonary wedge pressure , cardiac output , anesthesia , cardiology , stroke volume , afterload , ventricle , mean arterial pressure , dobutamine , blood pressure , heart rate , ventricular pressure , hemodynamics
Dopamine seems theoretically to be a rationale choice when adrenergic support is needed to counter undesired cardiovascular depressant effects of isoflurane. Although the cardiovascular effects of isoflurane (ISO) and exogenous dopamine (DA) are well documented, there are no reports on their pharmacological interaction. The effects of ISO 1.4% (MAC 1.0) on the cardiovascular response to exogenous DA were studied in dogs during chloralose anesthesia. Instrumentation included catheterizations of the femoral artery (for aortic pressures and heart rate, HR), the pulmonary artery (for thermodilution cardiac output, CO, and pulmonary arterial pressures) and the left ventricle (for tip‐manometer measured left ventricular end‐diastolic pressure, LVEDP). ISO per se decreased HR (‐16%), mean arterial pressure (MAP; ‐33%), CO (‐29%), left ventricular dP/dt (LV dP/dt; ‐51%), and increased pulmonary artery occlusion (PAOP; +64%) and LVEDP (+28%). Prior to ISO, DA increased MAP, CO stroke volume (SV), LV dP/dt and LV dP/dt/SAP (systolic arterial pressure) at the dose 10 ug · kg ‐1 · min ‐1 . At the dose 20 μf · kg ‐1 · min ‐1 DA, besides these effects, increased PAOP and mean pulmonary artery pressure (MPAP). During ISO , DA at the dose 10 μg · kg ‐1 · min ‐1 restored MAP, CO, and SV to pre‐ISO control levels, while LV dP/dt was increased to +96% above the pre‐ISO control level. At the dose 20 μg · kg ‐1 · min ‐1 , DA increased MAP (+33%), LV dP/dt (+172%), PAOP (+ 132%) and MPAP (+50%) above pre‐ISO control levels. The cardiac effects of DA were similar to when it was given alone. However, the increase in SVR (at the dose 20 μg · kg ‐1 · min ‐1 ) and MAP (at the 10 and 20 μg · kg ‐1 · min ‐1 doses) by DA was significantly more pronounced with ISO than without ISO. In conclusion, the pressor effects of DA seem to be potentiated by ISO. DA restores systemic arterial pressure during ISO anesthesia by attenuating the cardiac depressant effects of ISO and by increasing SVR above pre‐ISO control levels.