Effect of Various Propofol Plasma Concentrations on Regional Myocardial Contractility and Left Ventricular Afterload

Coetzee, André; Fourie, Paula; Coetzee, Johann F.; Badenhorst, E.; Rebel, A.; Bolliger, Chris T.; Uebel, Rosângela; Wium, Cherylynn Angela; Lombard, Carl

doi:10.1213/00000539-198910000-00009

Cited by 62 publications

(37 citation statements)

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“…The concentrations of propofol at which significant PTP inhibition is observed (50 pM) are at least tenfold the free plasma concentration detected after an intravenous bolus injection of propofol. However, the real cytosolic concentrations of propofol in cardiomyocytes are unknown, and cumulative effects of propofol after sustained intravenous administration have been reported [25]. The involvement of a propofol-PTP interaction in the cardiotoxicity of this anaesthetic remains to be evaluated.…”

Section: Discussionmentioning

confidence: 99%

Effects of the anaesthetic propofol on the calcium‐induced permeability transition of rat heart mitochondria: direct pore inhibition and shift of the gating potential

et al. 1995

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Mitochondrial calcium exchanges are involved in intracellular calcium homeostasis and in the contraction-relaxation process in myocytes. The calcium-induced permeability transition of the heart mitochondria inner membrane appears to be an important calcium efflux mechanism involved in some physiological and pathological situations. The negative inotropic effect of the anaesthetic propofol results in part from a decrease in intracellular calcium availability. Thus, this study evaluates the effects of propofol on calcium transport and permeability transition of heart mitochondria. The propofol-inhibition of the permeability transition of liver mitochondria was previously investigated [Eriksson, O. (1991) FEBS Lett. 279, 45-48] in such conditions that its uncoupling effect was not taken into account. We show here that propofol uncoupling results in a decrease in calcium uptake rate which could in part explain the decreased permeability transition rate. However, comparison of equlpotent uncoupling concentrations of propofol and carbonylcyanide m-chlorophenylhydrazone reveals that beyond this uncoupling effect, propofol has a direct inhibitory action on the permeability transition pore, concomittant with a shift of its gating potential.

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Section: Discussionmentioning

confidence: 99%

Effects of the anaesthetic propofol on the calcium‐induced permeability transition of rat heart mitochondria: direct pore inhibition and shift of the gating potential

et al. 1995

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“…However, in our study xenon was compared to propofol. It has been suggested from animal studies that the negative inotropic effect of propofol may be dose-dependent and not be present below a plasma concentration of 2.5 lg.ml )1 [30]. Wodey and coworkers, comparing the haemodynamic effects of propofol and thiopental in infants, reported only a slight decrease in myocardial contractility following propofol administration, not resulting in abnormal values compared to the awake state [31].…”

Section: Discussionmentioning

confidence: 99%

Comparison of xenon‐based anaesthesia compared with total intravenous anaesthesia in high risk surgical patients*

et al. 2005

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SummaryXenon, a noble gas with anaesthetic and analgesic properties, has gained renewed interest due to its favourable physical properties which allow a rapid emergence from anaesthesia. However, high costs limit its use to a subset of patients who may benefit from xenon, thereby offsetting its costs. To date, there are only limited data available on the performance of xenon in high risk patients. We studied 39 patients with ASA physical status III undergoing aortic surgery. The patients were randomly assigned to either a xenon (Xe, n = 20) or a TIVA (T, n = 19) group. Global cardiac performance and myocardial contractility were assessed using transoesophageal echocardiography, and myocardial cell damage with troponin T and CK-MB. Echocardiographic measurements were made prior to xenon administration, following xenon administration, and after clamping of the abdominal aorta, after declamping and at corresponding time points in the TIVA group. Laboratory values were determined repeatedly for up to 72 h. Data were analysed using two-way ANOVA factoring for time and anaesthetic agent or with ANCOVA comparing linear regression lines. No significant differences were found in global myocardial performance, myocardial contractility or laboratory values at any time during the study period. Mean (SEM) duration of stay on the ICU (xenon: 38 ± 46 vs. TIVA 25 ± 15 h) or in hospital (xenon: 14 ± 12 vs. TIVA 10 ± 6 days) did not differ significantly between the groups. Although xenon has previously been shown to exert superior haemodynamic stability, we were unable to demonstrate an advantage of xenon-based anaesthesia compared to TIVA in high risk surgical patients.

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“…Minimal changes in blood pressure may occur after midazolam administration as result of peripheral vasodilation 3 . In addition, propofol decreases arterial blood pressure as result of venodilation 8 and myocardial depression 4 . During this investigation, the blood pressure increased in the placebo group after incremental propofol, compared to the pressure that remained unaltered in the midazolam group.…”

Section: Discussionmentioning

confidence: 99%

Some cardiopulmonary effects of midazolam premedication in clenbuterol-treated bitches during surgical endoscopic examination of the uterus and ovariohysterectomy

Stegmann¹,

Bester²

2001

J. S. Afr. Vet. Assoc.

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Midazolam was administered intravenously to 8 bitches in a randomised, placebo-controlled clinical trial before propofol induction of surgical anaesthesia. Anaesthesia was maintained with isoflurane-in-oxygen during surgical endoscopic examination of the uterus and ovariohysterectomy. Clenbuterol was administered at the start of surgery to improve uterine muscle relaxation, and to facilitate endoscopic examination of the uterus. Ventilation was controlled. Induction of anaesthesia with propofol to obtain loss of the pedal reflex resulted in a statistically significant (P < 0.05) decrease in minute volume and arterial oxygen partial pressure in the midazolam group. Apnoea also occurred in 50 % of dogs in the midazolam group. The dose for propofol in the midazolam group was 7.4 mg/kg compared to 9.5 mg/kg in the control. Minute volume was significantly (P < 0.05) higher in both groups during isoflurane maintenance, compared to the value after incremental propofol to obtain loss of the pedal reflex. Propofol induction resulted in a 25-26 % reduction in the mean arterial blood pressure in both groups, and the administration of clenbuterol at the start of surgery resulted in a transient, but statistically significant (P < 0.05), decrease in mean arterial blood pressure in the midazolam group during isoflurane anaesthesia. It is concluded that intravenous midazolam premedication did not adversely affect cardiovascular function during propofol induction, but intra-operative clenbuterol during isoflurane maintenance of anaesthesia may result in transient hypotension. Midazolam premedication may increase adverse respiratory effects when administered before propofol induction of anaesthesia

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Effect of Various Propofol Plasma Concentrations on Regional Myocardial Contractility and Left Ventricular Afterload

Cited by 62 publications

References 0 publications

Effects of the anaesthetic propofol on the calcium‐induced permeability transition of rat heart mitochondria: direct pore inhibition and shift of the gating potential

Effects of the anaesthetic propofol on the calcium‐induced permeability transition of rat heart mitochondria: direct pore inhibition and shift of the gating potential

Comparison of xenon‐based anaesthesia compared with total intravenous anaesthesia in high risk surgical patients*

Some cardiopulmonary effects of midazolam premedication in clenbuterol-treated bitches during surgical endoscopic examination of the uterus and ovariohysterectomy

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