Hemodynamic Consequences of Abrupt Withdrawal of Nitroprusside or Nitroglycerin Following Induced Hypotension

Mm, Todd; Pj, Morris; Dm, Philbin

doi:10.1097/00132586-198212000-00006

Cited by 9 publications

(6 citation statements)

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“…KRN2391 is reported to have both a nitrate action and a potassium channel opening action. Todd et al [12] showed that nitroglycerin produced decreases in MAP and SVR and an increase in CO without affecting HR and right atrial pressure in halothane-anesthetized dogs. Gotanda et al [13] observed that the cardiovascular effects of cromakalim and pinacidil, both potassium channel openers, were characterized as vasodilators which preferentially reduced afterload and increased venous return in relating to increased cardiac output in pentobarbital-anesthetized dogs.…”

Section: Discussionmentioning

confidence: 99%

“…For such purposes, the security of regional blood flow without an increase in myocardial oxygen consumption is also important. Nitroglycerin has been shown to increase CO without affecting HR in halothane-anesthetized dogs [12]. However, the problem of tolerance to organic nitrates has been raised in human trials and in animal experiments [16][17][18].…”

Section: Discussionmentioning

confidence: 99%

“…However, rebound hypertension following the use of nitroprusside has been described [20]. Todd et al [12] reported that nitroprusside produced increases in MPAP, PCWP, PVR, and right atrial pressure after stopping infusion in halothane-anesthetized dogs. This rebound phenomenon caused by nitroprusside was also observed in patients who have received nitroprusside for treatment of congestive heart failure [21].…”

Section: Discussionmentioning

confidence: 99%

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Hemodynamic effects of KRN2391 (potassium channel opener) in halothane-anesthetized dogs

et al. 1995

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The cardiovascular responses to an infusion of KRN2391, a potassium channel opener, was studied in halothane-anesthetized dogs. Intravenous administration of KRN2391 at 1.0 and 5.0 μg·kg·min for 60 min produced dose-dependent decreases in mean arterial pressure (MAP) and systemic vascular resistance (SVR) associated with dose-dependent increases in the cardiac index (CI) and stroke volume index (SVI) but was not accompanied by an increase in heart rate (HR). The maximum decrease in MAP during the infusion of KRN2391 at 1.0 and 5.0 μg·kg·min was -13±7% (P<0.01) and -37±10% (P<0.01), respectively. The maximum reduction in SVR after 1.0 and 5.0 μg·kg·min was -20±11% (P<0.01) and -60±16% (P<0.01), respectively. A KRN2391 infusion of 1.0 and 5.0 μg·kg·min increased Cl a maximum of 11±13% (P<0.05) and 65±33% (P<0.01), respectively. KRN2391 1.0 μg·kg·min showed a tendency to increase SVI but this change was not significant, KRN2391 5.0 μg·kg·min, however, produced a significant increase in SVI. The present results demonstrate that the decrease in MAP and the increases in CI and SVI caused by KRN2391 are due to a reduction in the afterload. Therefore, we conclude that these cardiovascular profiles of KRN2391 may be benificial in perioperative uses including the control of systemic blood pressure and the treatment of hypertension during halothane anesthesia in clinical practice.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Hemodynamic effects of KRN2391 (potassium channel opener) in halothane-anesthetized dogs

et al. 1995

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“…Preferential dilation of the capacitance vessel by NTG was due to the higher threshold dose of this compound needed [21,22]. Indeed, a large amount of NTG has been reported to show a definite decrease in total peripheral resistance in the anesthetized dog [23,24]• Our results indicate that hypotension induced by either SNP or NTG was not associated with an increase in heart rate• This may have resulted from the use of enflurane, which is known to cause a depression of baroreflex regulation of the heart rate [25].…”

Section: Discussionmentioning

confidence: 99%

Effects of sodium nitroprusside (MR7S1) and nitroglycerin on the systemic, renal, cerebral, and coronary circulation of dogs anesthetized with enflurane

Hamaguchi

Ishibashi

Katsumata

et al. 1992

Cardiovasc Drug Ther

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In beagle dogs anesthetized with enflurane-nitrous oxide, effects of sodium nitroprusside (SNP; MR7S1) and nitroglycerin (NTG) on hemodynamics and main organ circulation were studied to evaluate their effectiveness and safety as hypotensive agents during anesthesia. SNP (MR7S1) infusion (1-10 micrograms/kg/min) decreased arterial blood pressure in a dose-dependent manner. The hypotension was stable during the infusion. After discontinuation of infusion, the blood pressure rapidly returned to the initial level. The hypotension was associated with decreases in cardiac output and total peripheral resistance. NTG infusion (3-10 micrograms/kg/min) decreased arterial blood pressure, too, but the hypotension was less marked and not dose dependent, and the recovery was slower. Neither drug changed the heart rate. Infusion of SNP (MR7S1) and NTG did not change the hypotension induced by the injection of adenosine, SNP, and NTG. Furthermore, cerebral blood flow, cerebral oxygen consumption, and renal blood flow were unchanged during the hypotension produced by either drug. Coronary blood flow was decreased, but this was due to decreases in cardiac oxygen consumption. In conclusion, SNP (MR7S1) is superior to NTG as a hypotensive agent during anesthesia in efficacy, clear dose dependency, and rapid recovery. The hypotension induced by NTG as well as SNP (MR7S1) seems to have no undesirable effects on the circulation of important organs.

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“…NTG-induced PGIi has been shown to contribute to the vasodilatory action of organic nitrates in the fetoplacental circulation [29]. This mechanism may also account for the difference in the effects of acute ter mination of SNP and NTG: a significant rebound hyper- tension frequently occurs after acute termination of SNP [30], but not NTG [31]. The involvement of PGH in vaso dilation caused by NTG, but not SNP, might be an expla nation for their potency differences at low concentrations, but this possibility has not been studied.…”

Section: Discussionmentioning

confidence: 99%

Gastric Arteriolar and Venular Responses to Nitrogenous and Nonnitrogenous Vasodilating Agents in the Rat

Chen

Ch²,

Guth³

1994

Int J Microcirc

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We made in vivo microvascular observations to simultaneously compare the actions of various direct vasodilators on the resistance and capacitance vessels without confounding systemic hemodynamic effects. The responses of gastric submucosal arteriolar and venular diameters to the topical application of 10^-7, 10^-5, and 10^-3M of the vasodilators nitroglycerin (NTG), sodium nitroprusside (SNP), hydralazine (HYD), and adenosine (ADN), and acetylcholine (ACh) were studied in 6 rats for each agent using in vivo microscopy. The basal diameters of arterioles, 37 ± 2 µm (mean ± SE), were maximally dilated to 86 ± 2 µm by 10^-3M ADN, NTG, SNP or ACh, while with 10^-3 M HYD dilation was just 55%. The basal diameters of venules, 36 ± 2 µm, were maximally dilated only to 51 ± 1 µm by 10^-3M ADN, NTG or SNP, while those by 10^-3M HYD and ACh were 60 and 71 %, respectively. We observed that: (1) NTG and SNP were the strongest arteriolar and venular dilators, but at low dose (10^-7M), NTG was more effective than SNP. (2) Gastric submucosal venules had considerably less dilating capacity than arterioles. (3) ADN was as effective as NTG and SNP for both arteriolar and venular dilation at 10^-3 M. It was less potent at lower concentrations. (4) ACh was as potent as ADN, NTG and SNP in dilating arterioles, but it was notably less potent in dilating venules. (5) HYD was the weakest arteriolar and venular dilator among all agents studied, and its action on venules was slightly greater than that on arterioles.

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Hemodynamic Consequences of Abrupt Withdrawal of Nitroprusside or Nitroglycerin Following Induced Hypotension

Cited by 9 publications

References 0 publications

Hemodynamic effects of KRN2391 (potassium channel opener) in halothane-anesthetized dogs

Hemodynamic effects of KRN2391 (potassium channel opener) in halothane-anesthetized dogs

Effects of sodium nitroprusside (MR7S1) and nitroglycerin on the systemic, renal, cerebral, and coronary circulation of dogs anesthetized with enflurane

Gastric Arteriolar and Venular Responses to Nitrogenous and Nonnitrogenous Vasodilating Agents in the Rat

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