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February 1, 1993Acta Anaesthesiologica Scandinavica

Evaluation of myocardial contractility in the chronically instrumented dog with intact autonomic nervous system function: effects of desflurane and isoflurane

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Why the study?

Does desflurane compared to isoflurane differentially affect myocardial contractility in chronically instrumented dogs with intact autonomic nervous system function?

Population

9 dogs chronically instrumented for measurement of aortic and left ventricular pressure, dP/dt…

Comparison

Desflurane at 1.25, 1.5, or 1.75 MAC vs Isoflurane at 1.25, 1.5, or 1.75 MAC

Design

Preclinical

Authors

PPPaul S. PagelStructural Heart DiseaseJKJohn P. KampineElectrophysiologyWSWilliam T. SchmelingMarquette University

Discussion

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Implication

Similar contractility effects in this canine model; leaves open translation to human anesthetic selection.

Key Points

  • To compare the effects of desflurane and isoflurane on left ventricular myocardial contractility in dogs with preserved autonomic nervous system reflexes.
  • Conducted 18 experiments across nine chronically instrumented dogs measuring left ventricular and intrathoracic pressures, cardiac output, and subendocardial segment length.
  • Used transient inferior vena cava occlusions and calculated transmural pressure to derive preload recruitable stroke work (PRSW) relations during conscious and anesthetized states (1.25, 1.5, and 1.75 MAC) after 30 minutes of equilibration.
  • Both volatile anesthetics produced dose-dependent reductions in myocardial contractile state compared to baseline.
  • PRSW slope (Mw) declined similarly at 1.75 MAC to 41 ± 6 mmHg (5.5 ± 0.8 kPa) for desflurane compared to 43 ± 5 mmHg (5.7 ± 0.7 kPa) for isoflurane, demonstrating equivalent myocardial depression at matching MAC levels.

Structured PICO

Does desflurane compared to isoflurane differentially affect myocardial contractility in chronically instrumented dogs with intact autonomic nervous system function?

P
Population
9 dogs chronically instrumented for measurement of aortic and left ventricular pressure, dP/dt, subendocardial segment length, cardiac output and intrathoracic pressure, with intact autonomic nervous system function.
I
Intervention
Desflurane at 1.25, 1.5, or 1.75 MAC
C
Comparator
Isoflurane at 1.25, 1.5, or 1.75 MAC
O
Outcome
Myocardial contractility evaluated using transmural pressure-length loops and calculation of the preload recruitable stroke work (PRSW) relationshipsurrogate

Desflurane and isoflurane cause similar dose-dependent depression of myocardial contractility in dogs with intact autonomic nervous system function.

Cite This Study

Pagel et al. (1993) studied this question.

synapsesocial.com/papers/6a891c8a3aa2d8278f760be2https://doi.org/10.1111/j.1399-6576.1993.tb03702.x
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Influence of Volatile Anesthetics on Myocardial Contractility In Vivo 1991 · 95 citations
  2. 2Comparison of End-Systolic Pressure—Length Relations and Preload Recruitable Stroke Work as Indices of Myocardial Contractility in the Conscious and Anesthetized, Chronically Instrumented Dog1990 · 61 citations
  3. 3Cardiovascular Actions of Desflurane in Normocarbic Volunteers1991 · 132 citations
  4. 4Comparison of measures of left ventricular contractile performance derived from pressure-volume loops in conscious dogs.1989 · 214 citations
  5. 5The end-systolic pressure-volume relationship in conscious dogs.1987 · 98 citations