Comparison of the Arrhythmic Doses of Epinephrine during Forane, Halothane, and Fluroxene Anesthesia in Dogs

Joas, Thomas A.; Stevens, Wendell C.

doi:10.1097/00000542-197107000-00015

Cited by 94 publications

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“…The interpretation of these findings assumes that equipotent anesthetic concentrations were present for both inhalation agents in the present and prior studies. Although we have not performed MAC studies in these animals, our anesthetic concentrations closely approximate previously published values for the MAC of enflurane and isoflurane in dogs (17,18). In the two studies, neither systemic nor coronary vasodilation was observed under the conditions of continuous diltiazem infusion at plasma diltiazem levels comparable to groups 1-111 with either inhalation anesthetic agent.…”

Section: Discussionsupporting

confidence: 80%

Plasma Diltiazem Levels, Cardiovascular Function, and Coronary Hemodynamics during Enflurane Anesthesia in the Dog

Kapur

Campos

Buchea

1986

Anesthesia & Analgesia

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KAPUR PA, CAMPOS JH, BUCHEA OC. Plasma diltjazem levels, cardiovascular function, and coronary hemodynamics during enflurane anesthesia in the dog. Anesth Analg 1986;65:918-24.Diltiazein 7ons ndininistered to dogs by a n intraueiious illfiisiori protocol, which resulted in plasma levels of 71 ? 6 ( I i = 7 ) , 139 ? 9 ( n = 7), 353 i 33 ( n = l o ) , and 1064 ? 143 (11 = 6) ng/ml, to ezialunte the effects of diltiazetn on i-nrrfiouasculur functioii mid coronar>y heinodynainics in the prescnce of mesthetic concentratioiis of enfluranc. An additional xroup of six dogs receizied enf7iirane only. The only c h a n p olwrued zilith eiiflurnne alone were 17 decrease in Icft z~entricular (LV) dPldt, cardinc index (Cl), nnd coronariy blood f7ozi1 60 inin after the haselirie m m i i r m e n t s were rnadr. I n all of fhe diltiazem groups, p l a s m leuel-related donga at ion of tkc PR interval of the elecfrocnrdiogrnrn iias observed, iiiith developinent of second degree henrt block and jrriictionnl rhythms in animals at the tziio hiRher plasma Jc~w/s. Mean nrterial pressure and LV dPidt decreased nt the two higher diltiazein plusinn leuels after 30 inin (if itrfusion, nnd three of six dogs in the highest group had to be dropped froin the study because of severe hypotension. The cardiac index ZORS no different from enflurane alone with the three lower plasma diltiazem levels. No changes were obserued in coronary sinus blood flow, coronary vascular resistnnce, inyocardinl oxygen uptake, or myocardial lactate extraction. Circulating norepinephrine levels were elevated in the tzoo higher diltiazein groups. In the presence of anesthetic coticentrations of enflurane, over the range of plasma diltiazein leziels investigated in this study, conduction effects w r e proriiinent and decreases in left ventricular performance and hlood pressure occurred as plasma diltiazem levels iiicreased. No untoward effects on global myocardial metnholisin zuere detected at plasma levels less than 500 ngi nil. However, the occurrence of circulatory collapse in half of the nninials at the highest plasma levels prevented evaluation of nietabolic effects of high levels of diltiazem during enflurane anesthesia.Diltiazem has a spectrum of clinical usefulness similar to that of verapamil (1-6). Because combined cardiovascular depressant effects may limit the use of verapamil in the presence of inhalation anesthestics (7), diltiazem may be a potential alternative if therapeutically indicated during inhalation anesthesia. Previous work in our laboratory has demonstrated that clinically relevant plasma levels of diltiazem are generally well-tolerated during 1.5% end-tidal isoflurane anesthesia in a canine model (8). Plasma level-related prolongation of the PR interval of the electrocardiogram and mild depression of left ventricular dPidt were the major findings. No alterations in global left ventricular oxygen consumption or coronary hemodynamics were noted. However, the previous study was limited to isoflurane and to plasma levels of diltiazem less than 60...

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Section: Discussionsupporting

confidence: 80%

Plasma Diltiazem Levels, Cardiovascular Function, and Coronary Hemodynamics during Enflurane Anesthesia in the Dog

Kapur

Campos

Buchea

1986

Anesthesia & Analgesia

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“…Nevertheless, the arrythmogenic plasma concentration of epinephrine obtained by us was 39.1 ng/rnl, which was nearly consistent with the 38.7 ng/rnl obtained by Sumikawa et al 7 This will therefore explain why the arrhythmogenic doses of epinephrine for halothane determined by us was substantially comparable to that determined by the above authors. 7,10,11 With regard to isoflurane, J oas et al 1 have reported that the arrhythmogenic doses of epinephrine determined during halothane and isoflurane anesthesia at 1.25 MAC by means of infusing precalculated doses of epinephrine for one minute were 5 f1gjkgjmin for halothane and 22 f1gjkgjmin for isoflurane. Tucker et al 3 have also reported experimental results similar to those obtained by Joas et al' that in dogs, isoflurane anesthesia required a dose of epinephrine four time as large as that required during halothane anesthesia in order to induce arrhythmias.…”

Section: Resultsmentioning

confidence: 99%

Comparison of the epinephrine-induced arrhythmogenic effect of sevoflurane with isoflurane and halothane

Imamura

Ikeda

1987

J Anesth

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The effect of sevoflurane on cardiac arrhythmias induced by the infusion of epinephrine into dogs was compared with those of isoflurane and halothane. The arrhythmogenic doses of epinephrine determined in this comparative study were expressed by both infusion rates of epinephrine and the corresponding plasma levels obtained by a series of three-minute epinephrine infusions during sevolurane, isoflurane, and halothane anesthesia at 1.25 MAC. The mean values of the arrythmogenic infusion rates of epinephrine and the corresponding plasma levels were 17.3 microg/kg/min and 275.7 ng/ml for sevoflurane, 6.7 microg/kg/min and 149.2 ng/ml for isoflurane and 1.9 microg/kg/min and 39.1 ng/ml for halothane, respectively. These results indicate that the arrythmogenic doses of epinephrine during sevoflurane and isoflurane anesthesia were significantly higher than those during halothane anesthesia.

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“…Minimum alveolar concentration of isoflurane at sea level has previously been reported to be approximately 1.28% 17 to 1.46%, 18 and surgical anesthesia generally requires a concentration 1.3 to 1.5 times the minimum alveolar concentration. Given that ambient barometric pressure at the study location (Fort Collins, Colo) was approximately 640 mm Hg, these values would have been lower (0.8% to 1.02%) if reported as a percentage of barometric pressure at sea level (760 mm Hg).…”

Section: Discussionmentioning

confidence: 98%

Cardiac output and other hemodynamic variables in anesthetized dogs undergoing laparotomy because of abdominal neoplasia

Wagner¹,

Miyake²

2008

javma

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Comparison of the Arrhythmic Doses of Epinephrine during Forane, Halothane, and Fluroxene Anesthesia in Dogs

Cited by 94 publications

References 0 publications

Plasma Diltiazem Levels, Cardiovascular Function, and Coronary Hemodynamics during Enflurane Anesthesia in the Dog

Plasma Diltiazem Levels, Cardiovascular Function, and Coronary Hemodynamics during Enflurane Anesthesia in the Dog

Comparison of the epinephrine-induced arrhythmogenic effect of sevoflurane with isoflurane and halothane

Cardiac output and other hemodynamic variables in anesthetized dogs undergoing laparotomy because of abdominal neoplasia

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