Left Ventricular Function During Propofol and Fentanyl Anesthesia in Patients With Coronary Artery Disease. Assessment With a Radionuclide Approach.

Changes in left ventricular end-diastolic area, end-systolic wall stress, and fractional area change during anesthetic induction with propofol or thiamylal

“…Propofol was infused in already anesthetized patients in the former study and in awake patients in the latter. We used propofol in awake patients, and our results are compatible with Lepage's results [5,10]. We measured EDA using TTE with automated border detection.…”

“…The LV enddiastolic volume (EDV) obtained from the modified Simpton's rule with TEE remained unchanged with propofol and thiopental [2,12]. Lepage et al [5,10], using gated radionuclide ventriculography, however, obtained decreased EDV with propofol. Propofol was infused in already anesthetized patients in the former study and in awake patients in the latter.…”

“…It appears, however, that the induction dose of propofol causes a greater fall in arterial blood pressure than barbiturates [1][2][3][4]. The precise mechanism of propofolinduced hypotension remains unclear, despite several clinical and experimental studies [5][6][7]. Several mechathe injection of the anesthetic agent and were then maintained on controlled ventilation with 100% oxygen to normocapnia.…”

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nisms have been postulated, including a reduction in myocardial contractility, alterations in loading conditions, and changes in the central nervous system [5][6][7][8][9][10][11]. In humans, left ventricular (LV) performance has been assessed during infusion of propofol using transesophageal echocardiography (TEE) [2,12].

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Intracoronary propofol does not decrease myocardial contractile function in the dog

“…As in our study, clinical concentrations of propofol had no direct effect on contractility. In humans, Lepage et al 12 relied on global ejection fraction Control (n = 6) 36.5 + 7.7 41.1 + 7.9 Thiopentone 20 ~g" ml -~ 34.4 + 7.9 37.5 -t-9.6 Thiopentone 40 I~g" ml -t 31.5 -t-7. and peak systolic/end systolic volume ratio (determined by radionuclide angiography) to assess contractility.…”