Abstract
The effect of anaesthesia induction drugs on the intestinal circulation was evaluated in an isolated loop preparation in 28 dogs. Selected intestinal loops were perfused with aortic blood by a pump at a constant pressure of 100 mmHg. A mixture of86Rb and 9 μn spheres labeled with141Ce was injected into the arterial cannula supplying the intestinal segment while mesenteric venous blood was collected for activity counting. Diazepam in a dose of 3 mg·kg-1 was accompanied by a significantly lower clearance (Cl-Rb), and permeability-surface area product (PS) than pentobarbitone; there were no differences between diazepam and pentobarbitone in total blood flow (BF), vascular resistance (VR) and oxygen consumption in the intestinal segments. Circulatory variables observed after midazolam, 8mgμkg-1 and an additional 16mgμkg-1, did not significantly differ from those seen during pentobarbitone. Ketamine in a dose of 8 mgμkg-1 was accompanied by a significantly lower BF, Cl-Rb, microsphere entrapment (Cl-Sph), PS, and higher VR and arterio-venous oxygen content difference. Sixteen mgμkg-1 of ketamine did not lead to any additional changes in determined variables of the intestinal circulation. Alpha-adrenoceptor blockade completely abolished vasoconstriction caused by ketamine, suggesting that the long-lasting vasoconstricting effect of ketamine on the intestinal circulation is mediated through catecholamines.
Résumé
Les effets des agents anesthésiques utilisés lors de I’induction sur la circulation intestinale ont été évalués chez 28 chiens utilisant une préparation où un circuit intestinal est isolé. Les circuits d’intestin choisis ont été perjusés avec du sang aortique utilisant une pompe à pression constante de 100 mmHg. Un mélange de Rb86 et des microsphères de 9 µm marqués avec du Ce 141 ont été injectés dans la canule artérielle nourissant le segment intestinal alors que le sang veineux mésentérique a été recueilli afin de mesurer la radioactivité résiduelle. Le diazepam à des doses de 3 mg-kg-1 a démontré une clairance de rubidium (Cl-Rb) et un produit surface-perméabilité (PS) significativement plus bas que le pentobarbitone. II n’y avait aucune différence entre le diazepam et le pentobarbitone quant au flot sanguin total (BF), résistance vasculaire (VR) et consommation d’oxygene des segments d’intestin. Les perturbations de la circulation observé.es après midazolam, 8 mg.kg-1 et une dose additionnelle de 16 mg-kg-1 n’etaient pas significativement différentes de celles observées lors de I’induction avec le pentobarbitone. La ketamine à des doses de 8mg-kg-1 était accompagnée par un Cl-Rb, un BF, une capture de microsphères (Cl-Sph), un PS, significativement plus bas. La VR et la différénce artério-veineuse du contenu en oxygène étaient plus hautes. 16mgkg-1 de ketamine n’ont pas amené des changements additionnels dans les variables étudiées. Un blocage des récepteurs alpha-adrénergiques a complètement aboli la vasoconstriction causée par la ketamine suggérant que I’effet vasoconstricteur de la ketamine est dû aux catécho-lamines.
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References
Forsyth RP, Hoffbrand BI. Redistribution of cardiac output after sodium pentobarbital anesthesia in the monkey. Am J Physiol 1970; 218: 214–7.
Sjostrom B, Wulff KE. Influence of long-term anesthesia on regional blood flow distribution and hemodynamics in the dog. Eur Surg Res 1975; 7: 1–9.
Bradshaw EG. The vasodilator effects of diazepam in vitro. Br J Anaesth 1976; 48: 817–8.
Cote P, Guret P, Bourassa MG. Systemic and coronary hemodynamic effects of diazepam in patients with normal and diseased coronary arteries. Circulation 1974; 50: 1210–6.
Clark RSJ, Lyons SM. Diazepam and flunitrazepam as induction agents for cardiac surgical operations. Acta Anaesthesiol Scand 1977; 21: 282–92.
Reves JG, Mardis M, Strong S. Cardiopulmonary effects of midazolam. Ala J Med Sci 1978; 15: 347–51.
Jones DJ, Stehling LC, Zander HL. Cardiovascular responses to diazepam and midazolam maleate in the dog. Anesthesiology 1979; 51: 430–4.
Reves JG, Samuelson PN, Lewis S. Midazolam induction in patients with ischaemic heart disease: haemodynamic observations. Can Anaesth Soc J 1979; 26: 402–9.
Samuelson PN, Reves JG, Kouchoulcos NT, Smith LR, Dole KM. Hemodynamic responses to anesthetic induction with midazolam or diazepam in patients with ischemic heart disease. Anesth Analg 1981; 60: 802–9.
Domino EF, Schodoff P, Corssen G. Pharmacologic effects of CI-581 a new dissociative anesthetic in man. J Clin Pharmacol 1965; 6: 279–84.
Slogqff S, Allen GW. The role of baroreceptors in the cardiovascular response to ketamie. Anesth Analg 1974; 53: 704–7.
Trabe DL, Wilson RD, Priano LL. Differentiation of the cardiovascular effects of CI-581. Anesth Analg 1968; 47: 769–78.
Traber DL, Wilson RD, Priano LL. Blockade of the hypertensive response to ketamine. Anesth Analg 1970; 49: 420–6.
Traber DL, Wilson RD, Priano LL. The effect of beta-adrenergic blockade on the cardiopulmonary response to ketamine. Anesth Analg 1970; 49: 604–13.
Traber DL, Wilson RD, Priano LL. A detailed study of the cardiopulmonary response to ketamine and its blockade by atropine. South Med J 1970; 63: 1077–81.
Traber DL, Wilson RD, Priano LL. The effect of alpha blockade on the cardiopulmonary response to ketamine. Anesth Analg 1971; 50: 737–42.
Manders WT, Vatner SF. Effects of sodium pentobarbital anesthesia on left ventricular function and distribution of cardiac output in dogs, with particular reference to the mechanism for tachycardia. Circ Res 1976; 39: 512–7.
Donald DE. Splanchnic circulation. In:Shepherd JT, Abboud FM, Geiger SR, eds. Handbook of physiology, The cardiovascular system. Bethesda: American Physiological Society, 1983: 219–40.
Gelman S, Reves JG, Harris D. Circulatory responses to midazolam anesthesia: emphasis on canine splanchnic circulation. Anesth Analg 1983; 62: 135–9.
Greenway CV. Role of splanchnic venous system in overall cardiovascular homeostasis. Fed Proc 1983; 42: 1678–84.
Gelman S, Granger DN, Fowler K, Smith LR. Clearance of 9 µm spheres and Rb in the intestinal circulation. Am J Physiol 1984; 247: G13–8.
Tverskoy M, Gelman S, Fowler KC, Bradley EL. Intestinal circulation during inhalation anesthesia. Anesthesiology 1985; 62: 462–9.
Tverskoy M, Gelman S, Fowler KC, Bradley EL. Influence of fentanyl and morphine on intestinal circulation. Anesth Analg 1985; 64: 577–84.
Maxwell RA, Plummer AJ, Povalski H, Schneider F. Concerning a possible action of guanethidine (SU-5864) in smooth muscle. J Pharmacol Exp Ther 1960; 129: 24–30.
Lievre M, Kofman J, Andrieu JL, Faucon G. Effects of two a-adrenoceptor antagonists, nicergo-line and phentolamine, on myocardial oxygen consumption in the dog. J Cardiovasc Pharmacol 1983; 5: 856–60.
Heymann MA, Payne BD, Hoffman JIE, Rudolph AM. Blood flow measurements with radionuclide-labeled particles. Prog Cardiovasc Dis 1977; XX: 55–79.
Gelman S, Reves JG, Fowler K, Samuelson PN, Lell WA, Smith LR. Regional blood flow during cross-clamping of the thoracic aorta and infusion of sodium nitroprusside. J Thorac Cardiovasc Surg 1983; 85: 287–91.
Baer RW, Payne BD, Verrier ED et al. Increased number of myocardial blood flow measurements with radionuclide-labeled microspheres. Am J Physiol 1984; 246: H418–34.
Shepherd AP. Intestinal capillary exchange capacity and oxygen uptake rate: applications of indicator dilution principles. In:Grander DN, Bulkley GB, eds. Measurements of blood flow: applications of the splanchnic circulation. Baltimore: Williams & Wilkins, 1981: 293–317.
Snedecor GW, Cochran WG. Statistical methods. Ames, Iowa, 1980, pp 175–8, 215–22, 233–4, 255–8.
SAS Institute Inc. SAS user’s guide: statistics. Cary, North Carolina, SAS Institute Inc. 1982: 113–99.
Dinda PK, Buel MG, DaCosta LR, Beckl T. Simultaneous estimation of arteriolar capillary, and shunt blood flow of the gut mucosa. Am J Physiol 1983; 245: G29–37.
Millard RW, Baig H, Vatner SF. Cardiovascular effects of radioactive microsphere suspensions and Tween 80 solutions. Am J Physiol 1977; 232: H331–4.
Gelman S, Mardis M. Splanchnic circulatory response to ketamine in stressed and unstressed dogs. Anesthesiology 1980; 53: S53.
Kissin I. Diazepam anesthesia and myocardial contractility. Anesthesiology 1980; 53: 78.
Pieri L, Schajfner R, Scherschlicht R et al. Pharmacology of midazolam. Arzneim-Forsch Drug Res 1981; 31: 2180–2201.
Brown CR, Sarnquist FH, Canup CA, Pedley TA. Clinical, electroencephalographic, and pharma-cokinetic studies of a water-soluble benzodiazepine, midazolam maleate. Anesthesiology 1979; 50: 467–70.
Smith MT, Eadie MJ, Brophy TO. The pharmacoki-netics of midazolam in man. Eur J Clin Pharmacol 1981; 19: 271–8.
MacLeod SM, Giles HG, Bengert B, Liu FF, Sellers EM. Age- and gender-related differences in di-azepam pharmacokinetics. J Clin Pharmacol 1979; 19: 15–9.
Ochs HR, Greenblatt DJ, Kaschel HJ, Klehr W, Divoll M, Abernethy DR. Diazepam kinetics in patients with renal insufficiency or hyperthyroidism. Br J Clin Pharmacol 1981; 12: 829–32.
Ziegler WH, Schalch E, Leishman B, Eckert M. Comparison of the effects of intravenously administered midazolam, triazolam and their hydroxy metabolites. Br J Clin Phramacol 1983; 16: 63s-69s.
Reves JG, Fragen RJ, Vinik R, Greenblatt DJ. Midazolam: pharmacology and uses. Anesthesiology 1985; 62: 310–24.
Altura BM, Altura BT, Carella A. The effect of ketamine on vascular smooth muscle function. Br J Pharmacol 1980; 70: 257–67.
Fukuda S, Murakawa T, Takeshita H, Toda N. Direct effects of ketamine on isolated canine cerebral and mesenteric arteries. Anesth Analg 1983; 62: 553–8.
Takki S, Nikki P, Jaattela A, Tammisto T. Ketamine and plasma catecholamines. Br J Anaesth 1972; 44: 1318–21.
Tokics L, Brismar B, Hedenstierna G, Lundh R. Oxygen uptake and central circulation during ketamine anaesthesia. Acta Anaesthesiol Scand 1983; 27: 318–22.
Zsigmond EK, Kelsch RC, Kothary SP. Rise in plasma free-norepinephrine during anesthetic in duction with ketamine. Behav Neuropsychiat 1975; 6: 81–4.
Appel E, Dudziak R, Palm D et al. Sympathoneural and sympathoadrenal activation during ketamine anesthesia. Eur J Clin Pharmacol 1979; 16: 91–5.
Virtue RW, Alanis JM, Mori M, Lafargue RT, Vogel JHK, Metcalf DR. An anaesthetic agent: 2-orthochlorophenyl, 2-methylamino cyclohexanone hydrochloride (CI-581). Anesthesiology 1967; 28: 823–33.
Tweed WA, Minuck M, Mymin D. Circulatory responses to ketamine anesthesia. Anesthesiology 1972; 37: 613–9.
Kvietys PR, Granger DN. Vasoactive agents and splanchnic oxygen uptake. Am J Physiol 1982; 243: G1-G9.
Fondacaro JK, Walus KM, Jacobson ED. Do either adenosine or prostacyclin mediate postprandial hyperemia in the gut? Gastroenterology 1981; 80: 1149.
Kvietys PR, Granger DN. Relation between intestinal blood flow and oxygen uptake. Am J Physiol 1982; 242: G202-G208.
Eger El II, Shingu K, Johnson BH. Hypoxia and halothane hepatotoxicity. Anesth Analg 1983; 62: 861.
Gelman S, Rimerman V, Fowler KC, Bishop SP, Bradley EL Jr. The effect of halothane, isoflur-ane, and blood loss on hepatotoxicity and hepatic oxygen availability in phenobarbital-pretreated hypoxic rats. Anesth Analg 1984; 63: 965–72.
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Tverskoy, M., Gelman, S., Fowler, K.C. et al. Effects of anaesthesia induction drugs on circulation in denervated intestinal loop preparation. Can Anaesth Soc J 32, 516–524 (1985). https://doi.org/10.1007/BF03010802
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DOI: https://doi.org/10.1007/BF03010802