Influence of Anesthesia on the Threshold of Pacing-Induced Ischemia
Increased myocardial oxygen demand, induced by increased heart rate, may cause myocardial ischemia in the presence of significant coronary artery disease. Alterations in anesthetic depth or technique might put at risk or protect myocardium with compromised blood flow. In 20 dogs with critical left a...
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| Veröffentlicht in: | Anesthesia and analgesia 1992-01, Vol.74 (1), p.14-25 |
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| container_title | Anesthesia and analgesia |
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| creator | Spahn, Donat R. Smith, L. Richard Veronee, Charles D. Hu, Wei-chih McRae, Robert L. Leone, Bruce J. |
| description | Increased myocardial oxygen demand, induced by increased heart rate, may cause myocardial ischemia in the presence of significant coronary artery disease. Alterations in anesthetic depth or technique might put at risk or protect myocardium with compromised blood flow. In 20 dogs with critical left anterior descending coronary artery (LAD) stenosis, atrial pacing rates from 100 to 160 beats/min were achieved, with end-tidal halothane 0.7% (LowH) and 1.1% (HighH), end-tidal isoflurane 1.1% (Lowl) and 1.5% (HighI), as well as with continuous fentanyl plus midazolam (FM) infusion anesthesia. Despite significantly different mean arterial and coronary perfusion pressures, rate-pressure product, and left ventricular dP/dtmax, the pacing rate at which systolic shortening decreased below the lower limit of the physiologic response, indicating regional dysfunction, was the same in all investigated anesthesia conditions (LowH127 ± 4 beats/min; HighH128 ± 5 beats/min; LowI125 ± 4 beats/min; HighI122 ± 5 beats/min; FM124 ± 4 beats/min [mean ± SEM], P > 0.05). None of the investigated anesthesia conditions either increased ischemia tolerance or showed a detrimental effect on myocardium with compromised coronary blood flow. |
| doi_str_mv | 10.1213/00000539-199201000-00004 |
| format | Article |
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Richard ; Veronee, Charles D. ; Hu, Wei-chih ; McRae, Robert L. ; Leone, Bruce J.</creator><creatorcontrib>Spahn, Donat R. ; Smith, L. Richard ; Veronee, Charles D. ; Hu, Wei-chih ; McRae, Robert L. ; Leone, Bruce J.</creatorcontrib><description>Increased myocardial oxygen demand, induced by increased heart rate, may cause myocardial ischemia in the presence of significant coronary artery disease. Alterations in anesthetic depth or technique might put at risk or protect myocardium with compromised blood flow. In 20 dogs with critical left anterior descending coronary artery (LAD) stenosis, atrial pacing rates from 100 to 160 beats/min were achieved, with end-tidal halothane 0.7% (LowH) and 1.1% (HighH), end-tidal isoflurane 1.1% (Lowl) and 1.5% (HighI), as well as with continuous fentanyl plus midazolam (FM) infusion anesthesia. Despite significantly different mean arterial and coronary perfusion pressures, rate-pressure product, and left ventricular dP/dtmax, the pacing rate at which systolic shortening decreased below the lower limit of the physiologic response, indicating regional dysfunction, was the same in all investigated anesthesia conditions (LowH127 ± 4 beats/min; HighH128 ± 5 beats/min; LowI125 ± 4 beats/min; HighI122 ± 5 beats/min; FM124 ± 4 beats/min [mean ± SEM], P > 0.05). 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Richard</creatorcontrib><creatorcontrib>Veronee, Charles D.</creatorcontrib><creatorcontrib>Hu, Wei-chih</creatorcontrib><creatorcontrib>McRae, Robert L.</creatorcontrib><creatorcontrib>Leone, Bruce J.</creatorcontrib><title>Influence of Anesthesia on the Threshold of Pacing-Induced Ischemia</title><title>Anesthesia and analgesia</title><addtitle>Anesth Analg</addtitle><description>Increased myocardial oxygen demand, induced by increased heart rate, may cause myocardial ischemia in the presence of significant coronary artery disease. Alterations in anesthetic depth or technique might put at risk or protect myocardium with compromised blood flow. In 20 dogs with critical left anterior descending coronary artery (LAD) stenosis, atrial pacing rates from 100 to 160 beats/min were achieved, with end-tidal halothane 0.7% (LowH) and 1.1% (HighH), end-tidal isoflurane 1.1% (Lowl) and 1.5% (HighI), as well as with continuous fentanyl plus midazolam (FM) infusion anesthesia. Despite significantly different mean arterial and coronary perfusion pressures, rate-pressure product, and left ventricular dP/dtmax, the pacing rate at which systolic shortening decreased below the lower limit of the physiologic response, indicating regional dysfunction, was the same in all investigated anesthesia conditions (LowH127 ± 4 beats/min; HighH128 ± 5 beats/min; LowI125 ± 4 beats/min; HighI122 ± 5 beats/min; FM124 ± 4 beats/min [mean ± SEM], P > 0.05). None of the investigated anesthesia conditions either increased ischemia tolerance or showed a detrimental effect on myocardium with compromised coronary blood flow.</description><subject>Anesthesia</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Animals</subject><subject>Biological and medical sciences</subject><subject>Cardiac Pacing, Artificial</subject><subject>Coronary Circulation - drug effects</subject><subject>Coronary Disease - physiopathology</subject><subject>Dogs</subject><subject>General anesthesia. Technics. Complications. Neuromuscular blocking. Premedication. Surgical preparation. Sedation</subject><subject>Halothane - pharmacology</subject><subject>Heart - drug effects</subject><subject>Hemodynamics - drug effects</subject><subject>Isoflurane - pharmacology</subject><subject>Medical sciences</subject><issn>0003-2999</issn><issn>1526-7598</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1992</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kTtPwzAUhS0EKqXwE5AyIDZD_IgfY1XxiFQJhjJbjmOTgJMUuxHi35OQUia82Pec715bxwAkKL1BGJHbdFwZkRBJiVM0FHBU6BGYowwzyDMpjsF8kAjEUspTcBbj21CiVLAZmCFOKOdsDlZ563xvW2OTziXL1sZdZWOtk65NhlOyqYKNVefL0X7Wpm5fYd6WvbFlkkdT2abW5-DEaR_txX5fgJf7u83qEa6fHvLVcg0NEZRCgwQWjhvsdFHIjGFXSF4UjKSGkUzTEkuCTEkxK7DGAlFbcpMJR7hgSGJKFuB6mrsN3Uc_vFQ1dTTWe93aro-KYy5FykdQTKAJXYzBOrUNdaPDl0KpGvNTv_mpQ34_0th6ub-jLxpb_jVOgQ3-1d7X0Wjvgm5NHQ9YlmaYUDxgdMI-O7-zIb77_tMGVVntd5X67_fIN7B4hUw</recordid><startdate>199201</startdate><enddate>199201</enddate><creator>Spahn, Donat R.</creator><creator>Smith, L. 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Richard ; Veronee, Charles D. ; Hu, Wei-chih ; McRae, Robert L. ; Leone, Bruce J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3844-c1828f7c2fabb9562fb97bb630c635a4d2931cd426b2a2814ed7c58f378619243</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1992</creationdate><topic>Anesthesia</topic><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Animals</topic><topic>Biological and medical sciences</topic><topic>Cardiac Pacing, Artificial</topic><topic>Coronary Circulation - drug effects</topic><topic>Coronary Disease - physiopathology</topic><topic>Dogs</topic><topic>General anesthesia. Technics. Complications. Neuromuscular blocking. Premedication. Surgical preparation. Sedation</topic><topic>Halothane - pharmacology</topic><topic>Heart - drug effects</topic><topic>Hemodynamics - drug effects</topic><topic>Isoflurane - pharmacology</topic><topic>Medical sciences</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Spahn, Donat R.</creatorcontrib><creatorcontrib>Smith, L. Richard</creatorcontrib><creatorcontrib>Veronee, Charles D.</creatorcontrib><creatorcontrib>Hu, Wei-chih</creatorcontrib><creatorcontrib>McRae, Robert L.</creatorcontrib><creatorcontrib>Leone, Bruce J.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Anesthesia and analgesia</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Spahn, Donat R.</au><au>Smith, L. Richard</au><au>Veronee, Charles D.</au><au>Hu, Wei-chih</au><au>McRae, Robert L.</au><au>Leone, Bruce J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Influence of Anesthesia on the Threshold of Pacing-Induced Ischemia</atitle><jtitle>Anesthesia and analgesia</jtitle><addtitle>Anesth Analg</addtitle><date>1992-01</date><risdate>1992</risdate><volume>74</volume><issue>1</issue><spage>14</spage><epage>25</epage><pages>14-25</pages><issn>0003-2999</issn><eissn>1526-7598</eissn><coden>AACRAT</coden><abstract>Increased myocardial oxygen demand, induced by increased heart rate, may cause myocardial ischemia in the presence of significant coronary artery disease. Alterations in anesthetic depth or technique might put at risk or protect myocardium with compromised blood flow. In 20 dogs with critical left anterior descending coronary artery (LAD) stenosis, atrial pacing rates from 100 to 160 beats/min were achieved, with end-tidal halothane 0.7% (LowH) and 1.1% (HighH), end-tidal isoflurane 1.1% (Lowl) and 1.5% (HighI), as well as with continuous fentanyl plus midazolam (FM) infusion anesthesia. Despite significantly different mean arterial and coronary perfusion pressures, rate-pressure product, and left ventricular dP/dtmax, the pacing rate at which systolic shortening decreased below the lower limit of the physiologic response, indicating regional dysfunction, was the same in all investigated anesthesia conditions (LowH127 ± 4 beats/min; HighH128 ± 5 beats/min; LowI125 ± 4 beats/min; HighI122 ± 5 beats/min; FM124 ± 4 beats/min [mean ± SEM], P > 0.05). None of the investigated anesthesia conditions either increased ischemia tolerance or showed a detrimental effect on myocardium with compromised coronary blood flow.</abstract><cop>Hagerstown, MD</cop><pub>International Anesthesia Research Society</pub><pmid>1734776</pmid><doi>10.1213/00000539-199201000-00004</doi><tpages>12</tpages></addata></record> |
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| source | MEDLINE; Journals@Ovid LWW Legacy Archive; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Journals@Ovid Complete |
| subjects | Anesthesia Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Animals Biological and medical sciences Cardiac Pacing, Artificial Coronary Circulation - drug effects Coronary Disease - physiopathology Dogs General anesthesia. Technics. Complications. Neuromuscular blocking. Premedication. Surgical preparation. Sedation Halothane - pharmacology Heart - drug effects Hemodynamics - drug effects Isoflurane - pharmacology Medical sciences |
| title | Influence of Anesthesia on the Threshold of Pacing-Induced Ischemia |
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