Effects of adenosine-induced hypotension on myocardial hemodynamics and metabolism in fentanyl anesthetized patients with peripheral vascular disease

A. Owall, Per-Olof Järnberg, L. A. Brodin, A. Sollevi

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

The effects of adenosine on central and myocardial hemodynamics and metabolism were evaluated during fentanyl anesthesia (100 μg·kg-1) in six patients with peripheral vascular disease. Adenosine was intravenously infused, at a rate of 90 ± 20 (SEM) μg·kg-1·min-1, to reduce mean arterial blood pressure by approximately 20% (23 ± 2% SEM, from 82 ± 3 to 63 ± 3 SEM mmHg) during a 20-min period. Systemic and pulmonary vascular resistance indices decreased by 36 ± 3 and 32 ± 6% (SEM). and cardiac index increased by 18 ± 5%. Heart rate, ventricular filling pressures, and whole body oxygen consumption were not affected by adenosine. Despite the reduced mean arterial blood pressure, coronary sinus flow increased by 128 ± 26% (SEM) in parallel with a 96 ± 11% (SEM) increase in coronary sinus oxygen content. Left and right ventricular stroke work indices, as well as myocardial oxygen consumption, were maintained. ECG (12-lead) demonstrated signs of ischemia in one subject, while myocardial lactate uptake was unchanged in all subjects. In conclusion, adenosine-induced hypotension in patients with peripheral vascular disease increased cardiac index without affecting myocardial work, whole body, and myocardial oxygen consumption. The marked increase in coronary sinus blood flow, indicating coronary vasodilation, was not related to increased myocardial work. Further information regarding myocardial effect of adenosine in patients with ischemic heart disease is warranted.

Original languageEnglish (US)
Pages (from-to)416-421
Number of pages6
JournalAnesthesiology
Volume68
Issue number3
StatePublished - 1988
Externally publishedYes

Fingerprint

Controlled Hypotension
Peripheral Vascular Diseases
Fentanyl
Adenosine
Hemodynamics
Coronary Sinus
Arterial Pressure
Oxygen Consumption
Vascular Resistance
Ventricular Pressure
Vasodilation
Myocardial Ischemia
Lactic Acid
Electrocardiography
Ischemia
Anesthesia
Heart Rate
Stroke
Oxygen

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Effects of adenosine-induced hypotension on myocardial hemodynamics and metabolism in fentanyl anesthetized patients with peripheral vascular disease. / Owall, A.; Järnberg, Per-Olof; Brodin, L. A.; Sollevi, A.

In: Anesthesiology, Vol. 68, No. 3, 1988, p. 416-421.

Research output: Contribution to journalArticle

@article{1ba6d8c06e1d44aab479a9580a0c5939,
title = "Effects of adenosine-induced hypotension on myocardial hemodynamics and metabolism in fentanyl anesthetized patients with peripheral vascular disease",
abstract = "The effects of adenosine on central and myocardial hemodynamics and metabolism were evaluated during fentanyl anesthesia (100 μg·kg-1) in six patients with peripheral vascular disease. Adenosine was intravenously infused, at a rate of 90 ± 20 (SEM) μg·kg-1·min-1, to reduce mean arterial blood pressure by approximately 20{\%} (23 ± 2{\%} SEM, from 82 ± 3 to 63 ± 3 SEM mmHg) during a 20-min period. Systemic and pulmonary vascular resistance indices decreased by 36 ± 3 and 32 ± 6{\%} (SEM). and cardiac index increased by 18 ± 5{\%}. Heart rate, ventricular filling pressures, and whole body oxygen consumption were not affected by adenosine. Despite the reduced mean arterial blood pressure, coronary sinus flow increased by 128 ± 26{\%} (SEM) in parallel with a 96 ± 11{\%} (SEM) increase in coronary sinus oxygen content. Left and right ventricular stroke work indices, as well as myocardial oxygen consumption, were maintained. ECG (12-lead) demonstrated signs of ischemia in one subject, while myocardial lactate uptake was unchanged in all subjects. In conclusion, adenosine-induced hypotension in patients with peripheral vascular disease increased cardiac index without affecting myocardial work, whole body, and myocardial oxygen consumption. The marked increase in coronary sinus blood flow, indicating coronary vasodilation, was not related to increased myocardial work. Further information regarding myocardial effect of adenosine in patients with ischemic heart disease is warranted.",
author = "A. Owall and Per-Olof J{\"a}rnberg and Brodin, {L. A.} and A. Sollevi",
year = "1988",
language = "English (US)",
volume = "68",
pages = "416--421",
journal = "Anesthesiology",
issn = "0003-3022",
publisher = "Lippincott Williams and Wilkins",
number = "3",

}

TY - JOUR

T1 - Effects of adenosine-induced hypotension on myocardial hemodynamics and metabolism in fentanyl anesthetized patients with peripheral vascular disease

AU - Owall, A.

AU - Järnberg, Per-Olof

AU - Brodin, L. A.

AU - Sollevi, A.

PY - 1988

Y1 - 1988

N2 - The effects of adenosine on central and myocardial hemodynamics and metabolism were evaluated during fentanyl anesthesia (100 μg·kg-1) in six patients with peripheral vascular disease. Adenosine was intravenously infused, at a rate of 90 ± 20 (SEM) μg·kg-1·min-1, to reduce mean arterial blood pressure by approximately 20% (23 ± 2% SEM, from 82 ± 3 to 63 ± 3 SEM mmHg) during a 20-min period. Systemic and pulmonary vascular resistance indices decreased by 36 ± 3 and 32 ± 6% (SEM). and cardiac index increased by 18 ± 5%. Heart rate, ventricular filling pressures, and whole body oxygen consumption were not affected by adenosine. Despite the reduced mean arterial blood pressure, coronary sinus flow increased by 128 ± 26% (SEM) in parallel with a 96 ± 11% (SEM) increase in coronary sinus oxygen content. Left and right ventricular stroke work indices, as well as myocardial oxygen consumption, were maintained. ECG (12-lead) demonstrated signs of ischemia in one subject, while myocardial lactate uptake was unchanged in all subjects. In conclusion, adenosine-induced hypotension in patients with peripheral vascular disease increased cardiac index without affecting myocardial work, whole body, and myocardial oxygen consumption. The marked increase in coronary sinus blood flow, indicating coronary vasodilation, was not related to increased myocardial work. Further information regarding myocardial effect of adenosine in patients with ischemic heart disease is warranted.

AB - The effects of adenosine on central and myocardial hemodynamics and metabolism were evaluated during fentanyl anesthesia (100 μg·kg-1) in six patients with peripheral vascular disease. Adenosine was intravenously infused, at a rate of 90 ± 20 (SEM) μg·kg-1·min-1, to reduce mean arterial blood pressure by approximately 20% (23 ± 2% SEM, from 82 ± 3 to 63 ± 3 SEM mmHg) during a 20-min period. Systemic and pulmonary vascular resistance indices decreased by 36 ± 3 and 32 ± 6% (SEM). and cardiac index increased by 18 ± 5%. Heart rate, ventricular filling pressures, and whole body oxygen consumption were not affected by adenosine. Despite the reduced mean arterial blood pressure, coronary sinus flow increased by 128 ± 26% (SEM) in parallel with a 96 ± 11% (SEM) increase in coronary sinus oxygen content. Left and right ventricular stroke work indices, as well as myocardial oxygen consumption, were maintained. ECG (12-lead) demonstrated signs of ischemia in one subject, while myocardial lactate uptake was unchanged in all subjects. In conclusion, adenosine-induced hypotension in patients with peripheral vascular disease increased cardiac index without affecting myocardial work, whole body, and myocardial oxygen consumption. The marked increase in coronary sinus blood flow, indicating coronary vasodilation, was not related to increased myocardial work. Further information regarding myocardial effect of adenosine in patients with ischemic heart disease is warranted.

UR - http://www.scopus.com/inward/record.url?scp=0023928394&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0023928394&partnerID=8YFLogxK

M3 - Article

VL - 68

SP - 416

EP - 421

JO - Anesthesiology

JF - Anesthesiology

SN - 0003-3022

IS - 3

ER -