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Ulusoy KG, Dogan MF, Cam SA, Arslan SO, Yildiz O. Propofol Relaxes Isolated Rat Aorta through BKCa Activation. Ann Vasc Surg 2019; 60:397-406. [DOI: 10.1016/j.avsg.2019.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 04/12/2019] [Accepted: 04/13/2019] [Indexed: 12/01/2022]
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Sohn JT, Kim HJ, Cho HC, Shin IW, Lee HK, Chung YK. Effect of Etomidate on Endothelium-dependent Relaxation Induced by Acetylcholine in Rat Aorta. Anaesth Intensive Care 2019; 32:476-81. [PMID: 15682522 DOI: 10.1177/0310057x0403200404] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The goals of this in vitro study were to investigate effects of etomidate on endothelium-dependent relaxation induced by acetylcholine in rat aorta, and to elucidate the associated cellular mechanism. In endothelium-intact rings precontracted with phenylephrine 10−6 M, dose-response curves for acetylcholine (10−9 to 10−5 M) and calcium ionophore (10−9 to 10−6 M) were generated in the presence and absence of etomidate (5×10−6, 10−5 M). In endothelium-intact or -denuded rings precontracted with phenylephrine 10−6 M, sodium nitroprusside (10−9 to 10−6 M) dose-response curves were generated in the presence and absence of etomidate (10−5 M). Etomidate (5×10−6, 10−5 M) produced a significant rightward shift in the dose-response curves induced by acetylcholine (receptor-mediated endothelium-dependent agonist) and calcium ionophore A23187 (non receptor-mediated endothelium-dependent agonist). Etomidate (10−5 M) had no effect on sodium nitroprusside (endothelium-independent nitric oxide donor)-induced vasorelaxant response in both endothelium-intact and -denuded rings. These results indicate that etomidate at clinically relevant concentrations attenuates endothelium-dependent relaxation induced by acetylcholine by an acting at a site distal to the endothelial muscarinic receptor, but proximal to guanylate cyclase activation of vascular smooth muscle in rat aorta.
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Affiliation(s)
- J-T Sohn
- Department of Anesthesiology and Pain Medicine, College of Medicine, Gyeongsang Institute of Health Sciences, Gyeongsang National University, Jinju, Republic of Korea
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Xue W, Li Y, Li J, Yan L, Yang F. Endothelium-dependent relaxation induced by etomidate in the aortas of insulin-resistant rats. Arch Med Sci 2018; 14:1155-1162. [PMID: 30154900 PMCID: PMC6111356 DOI: 10.5114/aoms.2018.77256] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Accepted: 12/15/2016] [Indexed: 12/20/2022] Open
Abstract
INTRODUCTION Few reports have mentioned the effect of etomidate on the aortas of insulin-resistant (IR) rats. In this study, we investigated the effect of etomidate on isolated IR aortas of rats, and explored its underlying mechanism. MATERIAL AND METHODS The IR rat model was established through feeding with a high-fructose diet. The systolic blood pressure (SBP) was measured by the tail-cuff method before grouping and at the end of the 8-week feeding; blood samples were also obtained for analysis. Thoracic aorta rings of IR rats were isolated and suspended in a tissue bath. The tensile force was recorded isometrically. The effect of etomidate on provoked contraction of the rings was assessed with or without a potassium channel blocker or NO synthase inhibitor. RESULTS Etomidate-induced relaxation in IR rings was greater than normal control (NC) rings (all p < 0.001 with etomidate log M of -4 to -6). NG-nitro-L-arginine methyl ester (L-NAME, an NO synthase inhibitors) inhibited etomidate-induced relaxation in NC rings, but had no effect on the IR rings (all p < 0.001 with etomidate log M of -4 to -6). Pre-incubation with glibenclamide (Gli, a potassium channel blocker) significantly inhibited etomidate-induced relaxation in NC and IR rings (all p < 0.001 with etomidate log M of -4 to -6), and had no inhibited effect on endothelial denuded aortic rings. CONCLUSIONS Insulin resistance increased etomidate-induced relaxation in rat aortas. Etomidate causes vasodilation in IR rat aortas via both endothelium-dependent and independent ways; impaired NO-mediated relaxation was disrupted and ATP-sensitive potassium (KATP) channel-mediated relaxation may be involved in the endothelium-dependent relaxation of etomidate in IR rats.
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Affiliation(s)
- Wenxin Xue
- Department of Pharmacy, Meitan General Hospital, Beijing, China
| | - Yiwen Li
- Department of Pharmacy, Meitan General Hospital, Beijing, China
| | - Jing Li
- Department of Pharmacy, Meitan General Hospital, Beijing, China
| | - Li Yan
- Department of Physiology and Pathophysiology, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Fang Yang
- Department of Neurology, Meitan General Hospital, Beijing, China
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郝 宁, 邓 春, 邝 素, 马 珏, 张 光, 崔 建. [Effects of propofol combined with indomethacin on contraction of isolated human pulmonary arteries]. NAN FANG YI KE DA XUE XUE BAO = JOURNAL OF SOUTHERN MEDICAL UNIVERSITY 2017; 37:342-346. [PMID: 28377350 PMCID: PMC6780431 DOI: 10.3969/j.issn.1673-4254.2017.03.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To investigate the effects of propofol combined with indomethacin on the contractile function of isolated human pulmonary arteries. METHODS Human pulmonary artery preparations were obtained from patients undergoing surgery for lung carcinoma. The intrapulmonary arteries were dissected and cut into rings under microscope for treatment with propofol or propofol combined with indomethacin. In each group, the rings were divided into endothelium-intact and endothelium-denuded groups and mounted in a Multi Myograph system. In propofol group, the rings were preconstricted by U46619 to induce a sustained contraction, and propofol (10-300 mmol/L) was then applied cumulatively. In the combined treatment group, the rings were pretreated with indomethacin (100 µmol/L) for 30 min before application of U46619 to induce sustained contraction, and propofol (10-300 µmol/L) was added cumulatively after the tension became stable. RESULTS Propofol (10-100 µmol/L) induced constrictions at low concentrations and caused relaxations at higher concentrations (100-300 µmol/L) in the pulmonary artery rings with prior U46619-induced contraction. Propofol caused stronger constrictions in endothelium-intact rings [EC50=4.525∓0.37, Emax=(30.44∓2.92)%] than in endothelium-denuded rings [EC50=4.699∓0.12, Emax=(31.19∓5.10)%, P<0.05]. Pretreatment of the rings with indomethacin abolished constrictions, and the relaxation was more obvious in endothelium-intact group [pD2=3.713∓0.11, Emax=(98.72∓0.34)%] than in endothelium- denuded group [pD2=3.54∓0.03, Emax=(94.56∓0.53)%, P<0.05]. CONCLUSION Propofol induces constriction at low concentrations and relaxation at high concentrations in human intrapulmonary arteries with U46619-induced contraction. Indomethacin abolishes the constriction induced by propofol in isolated intrapulmonary arteries, suggesting that propofol potentiates U46619-mediated pulmonary vasoconstriction by promoting the concomitant production of prostaglandin by cyclooxygenase in pulmonary artery smooth muscle cells, and the mechanism for its relaxation effect may partly depend on the endothelium.
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Affiliation(s)
- 宁 郝
- 南方医科大学,广东 广州 510515Postgraduate Institute, Southern Medical University, Guangzhou 510515, China
- 广东省医学科学院//广东省人民医院,麻醉科,广东 广州 510080Department of Anesthesiology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangdong Provincial Cardiovascular Institute, Guangzhou 510080, China
| | - 春玉 邓
- 广东省医学科学院//广东省人民医院,广东 广州 510080Medical Research Center, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangdong Provincial Cardiovascular Institute, Guangzhou 510080, China
| | - 素娟 邝
- 广东省医学科学院//广东省人民医院,广东 广州 510080Medical Research Center, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangdong Provincial Cardiovascular Institute, Guangzhou 510080, China
| | - 珏 马
- 广东省医学科学院//广东省人民医院,麻醉科,广东 广州 510080Department of Anesthesiology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangdong Provincial Cardiovascular Institute, Guangzhou 510080, China
| | - 光燕 张
- 广东省医学科学院//广东省人民医院,麻醉科,广东 广州 510080Department of Anesthesiology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangdong Provincial Cardiovascular Institute, Guangzhou 510080, China
| | - 建修 崔
- 南方医科大学,广东 广州 510515Postgraduate Institute, Southern Medical University, Guangzhou 510515, China
- 广东省医学科学院//广东省人民医院,麻醉科,广东 广州 510080Department of Anesthesiology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangdong Provincial Cardiovascular Institute, Guangzhou 510080, China
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Propofol-induced Inhibition of Catecholamine Release Is Reversed by Maintaining Calcium Influx. Anesthesiology 2016; 124:878-84. [PMID: 26808630 DOI: 10.1097/aln.0000000000001015] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND Propofol (2,6-diisopropylphenol) is one of the most frequently used anesthetic agents. One of the main side effects of propofol is to reduce blood pressure, which is thought to occur by inhibiting the release of catecholamines from sympathetic neurons. Here, the authors hypothesized that propofol-induced hypotension is not simply the result of suppression of the release mechanisms for catecholamines. METHODS The authors simultaneously compared the effects of propofol on the release of norepinephrine triggered by high K-induced depolarization, as well as ionomycin, by using neuroendocrine PC12 cells and synaptosomes. Ionomycin, a Ca ionophore, directly induces Ca influx, thus bypassing the effect of ion channel modulation by propofol. RESULTS Propofol decreased depolarization (high K)-triggered norepinephrine release, whereas it increased ionomycin-triggered release from both PC12 cells and synaptosomes. The propofol (30 μM)-induced increase in norepinephrine release triggered by ionomycin was dependent on both the presence and the concentration of extracellular Ca (0.3 to 10 mM; n = 6). The enhancement of norepinephrine release by propofol was observed in all tested concentrations of ionomycin (0.1 to 5 μM; n = 6). CONCLUSIONS Propofol at clinically relevant concentrations promotes the catecholamine release as long as Ca influx is supported. This unexpected finding will allow for a better understanding in preventing propofol-induced hypotension.
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Addison MP, Singh TU, Parida S, Choudhury S, Kasa JK, Sukumaran SV, Darzi SA, Kandasamy K, Singh V, Kumar D, Mishra SK. NO synthase inhibition attenuates EDHF-mediated relaxation induced by TRPV4 channel agonist GSK1016790A in the rat pulmonary artery: Role of TxA2. Pharmacol Rep 2016; 68:620-6. [DOI: 10.1016/j.pharep.2016.01.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Revised: 01/01/2016] [Accepted: 01/04/2016] [Indexed: 11/26/2022]
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Regulatory effects of anesthetics on nitric oxide. Life Sci 2016; 151:76-85. [DOI: 10.1016/j.lfs.2016.02.094] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2015] [Revised: 02/20/2016] [Accepted: 02/26/2016] [Indexed: 12/26/2022]
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Aguirre JA, Lucchinetti E, Clanachan AS, Plane F, Zaugg M. Unraveling Interactions Between Anesthetics and the Endothelium. Anesth Analg 2016; 122:330-48. [DOI: 10.1213/ane.0000000000001053] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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Hu YJ, Wei AN, Chook P, Yin Y, Cheng W, Wu MJ, Celermajer DS, Woo KS. Impact of non-cardiovascular surgery on reactive hyperaemia and arterial endothelial function. Clin Exp Pharmacol Physiol 2014; 40:466-72. [PMID: 23662794 DOI: 10.1111/1440-1681.12111] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2012] [Revised: 05/02/2013] [Accepted: 05/07/2013] [Indexed: 11/28/2022]
Abstract
Vascular reactivity is a surrogate marker for atherosclerosis and is predictive of cardiovascular outcome. Non-cardiovascular surgery is associated with perioperative cardiovascular complications in high-risk patients. To evaluate the impact of non-cardiovascular surgery on reactive hyperaemia and arterial endothelial function and to investigate the relationships between endothelial dysfunction and invasive (laparotomy) or minimally invasive (laparoscopic) surgery, we prospectively evaluated 106 patients undergoing abdominal surgery under general anaesthesia (71 laparotomy, 35 laparoscopy). Measurements of blood pressure, heart rate and pain (on a visual analogue scale (VAS)) were undertaken. Brachial endothelium-dependent flow-mediated dilation (FMD), endothelium-independent dilation, nitroglycerin (NTG)-induced dilation and reactive hyperaemia were measured with high-resolution B-mode ultrasound on preoperative Day 1 (baseline), as well as 2 h and 1 and 7 days postoperatively. Blood pressure and heart rate were significantly higher 2 h postoperatively. Pain, as measured on the VAS, was higher (P < 0.01) and reactive hyperaemia and FMD were significantly lower (P < 0.001) at 2 h and 1 day postoperatively compared with values at baseline and on postoperative Day 7. By postoperative Day 7, FMD had recovered to baseline levels. Patients undergoing laparoscopic surgery had less FMD reduction on Days 1 and 7 (7.5 ± 1.5% and 7.9 ± 1.5%, respectively) compared with those undergoing laparotomy (6.4 ± 1.6% (P = 0.001) and 7.0 ± 1.6% (P = 0.006), respectively), consistent with potential cardiovascular benefit. Responses to NTG were stable throughout. Backward multivariate linear regression analysis indicated that FMD was independently related to age and VAS (model R = 0.486; F = 6.4; P < 0.001). Reactive hyperaemia and arterial endothelial function are significantly reduced in the early postoperative period, particularly after laparotomy compared with laparoscopy, which may be related to postoperative cardiovascular events.
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Affiliation(s)
- Yan Jun Hu
- The Second Affiliated Hospital, Chongqing University of Medical Sciences, Chongqing, China
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Feussner M, Mukherjee C, Garbade J, Ender J. Anaesthesia for patients undergoing ventricular assist-device implantation. Best Pract Res Clin Anaesthesiol 2012; 26:167-77. [DOI: 10.1016/j.bpa.2012.06.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2012] [Revised: 06/04/2012] [Accepted: 06/04/2012] [Indexed: 01/03/2023]
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Kuriyama T, Tokinaga Y, Tange K, Kimoto Y, Ogawa K. Propofol attenuates angiotensin II-induced vasoconstriction by inhibiting Ca2+-dependent and PKC-mediated Ca2+ sensitization mechanisms. J Anesth 2012; 26:682-8. [DOI: 10.1007/s00540-012-1415-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2011] [Accepted: 05/07/2012] [Indexed: 10/28/2022]
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Krzych LJ, Szurlej D, Bochenek A. Rationale for Propofol Use in Cardiac Surgery. J Cardiothorac Vasc Anesth 2009; 23:878-85. [DOI: 10.1053/j.jvca.2009.05.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2008] [Indexed: 11/11/2022]
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Effects of propofol on responses of rat isolated renal arteriole to vasoactive agents. Vascul Pharmacol 2009; 51:182-9. [DOI: 10.1016/j.vph.2009.06.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2009] [Revised: 04/13/2009] [Accepted: 06/09/2009] [Indexed: 11/17/2022]
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Gragasin FS, Davidge ST. The effects of propofol on vascular function in mesenteric arteries of the aging rat. Am J Physiol Heart Circ Physiol 2009; 297:H466-74. [DOI: 10.1152/ajpheart.01317.2008] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Hypotension following administration of propofol, an anesthetic agent, is strongly predicted by advanced age and is partly due to direct vasodilation. We hypothesized that propofol increases nitric oxide (NO)-mediated vasodilation by enhancing its bioavailability in the aged adult vasculature, leading to greater vasodilation than in the young adult. Small mesenteric arteries from rats aged 13–15 versus 3 to 4 mo were compared in this study. Reactivity to propofol (1–100 μM) alone and with the addition of acetylcholine (ACh; 0.1–10 μM) in endothelial-intact and dunuded arteries following phenylephrine constriction was assessed using myography. NG-nitro-l-arginine methyl ester (l-NAME) and meclofenamate (Meclo) were used to inhibit NO and prostaglandin synthesis, respectively. Superoxide dismutase (SOD) and catalase were used as antioxidants during ACh relaxation and were compared with propofol in aging arteries. Propofol alone induced greater relaxation in 1) endothelial-intact compared with denuded arteries and 2) aged compared with young arteries, which were inhibited by l-NAME. ACh-induced relaxation was greater in young compared with aged control arteries; however, propofol pretreatment increased this relaxation in aged but not in young arteries. Additionally, propofol inhibited ACh-induced relaxation in arteries treated with l-NAME + Meclo [relaxation attributed to endothelium-derived hyperpolarizing factor (EDHF)]. Pretreatment with SOD and catalase increased relaxation to ACh in aged arteries similar to propofol. In conclusion, propofol causes relaxation in small mesenteric arteries in an endothelial-dependent and independent manner and increases ACh-induced relaxation in aged arteries. Interestingly, propofol inhibits EDHF-mediated relaxation but increases availability of NO, which leads to overall vascular relaxation.
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Baumgartner C, Bollerhey M, Henke J, Wagner S, Ungerer M, Erhardt W. Effects of propofol on ultrasonic indicators of haemodynamic function in rabbits. Vet Anaesth Analg 2008; 35:100-12. [PMID: 17850227 DOI: 10.1111/j.1467-2995.2007.00360.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
OBJECTIVE To evaluate the cardiovascular effects of intravenous propofol in rabbits. STUDY DESIGN Randomized, prospective, experimental study. ANIMALS Thirty-one female New Zealand White rabbits. METHODS Rabbits were allocated to one of two groups [propofol (P) or conscious (C)]. In C (n = 16) vascular dimensions were measured using ultrasound of the left common carotid artery (ACC) and the abdominal aorta (AA). Group P (n = 15) received propofol 4.0-8.0 mg kg(-1) intravenously (IV). Anaesthesia was maintained with propofol at 1.2-1.3 mg kg(-1) minute(-1). Subsequently, three propofol injections (8 mg kg(-1)) were given. Before and for 10 minutes after each injection the following vascular and haemodynamic variables were recorded (a) at the ACC after the first injection; and (b) at the AA after the second injection: vessel diameter [D, (mm)], peak systolic, minimum diastolic, end-diastolic and average blood flow velocities [psBFV, mdBFV, edBFV, Vave (cm second(-1))], average volumetric flow [VFave (mL s(-1))], resistance index (RI) and pulsatility index (PI) mean arterial pressure (MAP), heart rate (HR), arterial oxygen saturation (SpO(2)) and end-tidal CO(2) (Pe'CO(2)). Echocardiography was performed after the third propofol bolus injection to investigate changes in cardiac parameters [fractional shortening, FS (%)]. RESULTS Intravenous propofol injections caused a significant decrease in vessel diameter, volumetric flow and edBFV, and significant increases in psBFV, RI and PI. Baseline levels for vessel diameter and psBFV were restored 6-8 minutes after injection. Propofol injection decreased FS significantly by 7 minutes after injection while MAP and HR were significantly reduced for 4 minutes. CONCLUSION AND CLINICAL RELEVANCE Injections of propofol (8 mg kg(-1)) produced an immediate, transient decrease in vascular diameters, a significant decrease in ventricular performance and an increase in peripheral vascular resistance (ACC and AA). Propofol should probably not be or only carefully used in rabbits with ventricular dysfunction.
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Affiliation(s)
- Christine Baumgartner
- Working Group of Experimental Surgery, Institute for Experimental Oncology and Therapeutic Research, Technical University, Munich, Germany.
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Lai HC, Lai HC, Wang KY, Lee WL, Ting CT, Liu TJ. Severe pulmonary hypertension complicates postoperative outcome of non-cardiac surgery. Br J Anaesth 2007; 99:184-90. [PMID: 17576968 DOI: 10.1093/bja/aem126] [Citation(s) in RCA: 146] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Whether and how pulmonary hypertension (PH) impacts perioperative outcome in non-cardiac surgery is incompletely understood. METHODS From November 1999, all patients undergoing non-cardiac, non-local anaesthetic surgery and ever examined by echocardiography within 30 days before surgery were screened. Those having echocardiographic pulmonary artery systolic pressure >70 mm Hg were enrolled provided they were not already intubated. Case-matched peers with normal pulmonary pressures served as controls. Perioperative outcomes were compared between the two groups, and predictors of adverse perioperative outcomes were investigated by multivariate logistic regression analysis. RESULTS From November 1999 to August 2004, a total of 62 patients (male 38, mean age 67 yr) with PH were found. Compared with the case-matched controls, patients with PH experienced equivalently smooth operative courses, but significantly more frequent postoperative heart failure (9.7 vs 0%, P = 0.028), delayed tracheal extubation (21 vs 3%, P = 0.004), and in-hospital deaths (9.7 vs 0%, P = 0.028). Multivariate regression analysis identified emergency surgery [odds ratio (OR), 44.738; P = 0.028], coronary artery disease (CAD; OR, 9.933; P = 0.042), and systolic pulmonary artery pressure (OR, 1.101; P = 0.026) as independent predictors of postoperative mortality and surgery-specific cardiac risk level (OR, 6.791; P = 0.033) and CAD (OR 6.546, P = 0.017) as predictors of morbidity. CONCLUSION PH is an important predictor of adverse cardiopulmonary outcome in non-cardiac surgery as reflected by markedly increased postoperative complications, especially in patients with coexistent high-risk clinical and surgical characteristics.
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Affiliation(s)
- H-C Lai
- Department of Anaesthesiology, Taichung Veterans General Hospital, Taichung, Taiwan
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Sohn JT, Shin IW. The Cellular Signal Transduction Pathways for Production and Release of Nitric Oxide from Endothelial Cells. Korean J Anesthesiol 2007. [DOI: 10.4097/kjae.2007.53.1.150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- Ju-Tae Sohn
- Department of Anesthesiology and Pain Medicine, Gyeongsang National University College of Medicine, Jinju, Korea
- Institute of Health Sciences, Gyeongsang National University College of Medicine, Jinju, Korea
| | - Il-Woo Shin
- Department of Anesthesiology and Pain Medicine, Gyeongsang National University College of Medicine, Jinju, Korea
- Institute of Health Sciences, Gyeongsang National University College of Medicine, Jinju, Korea
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Schäfer SC, Wallerath T, Closs EI, Schmidt C, Schwarz PM, Förstermann U, Lehr HA. Dexamethasone suppresses eNOS and CAT-1 and induces oxidative stress in mouse resistance arterioles. Am J Physiol Heart Circ Physiol 2005; 288:H436-44. [PMID: 15598872 DOI: 10.1152/ajpheart.00587.2004] [Citation(s) in RCA: 71] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Long-term treatment with glucocorticoids is associated with mild to moderate hypertension. We reported previously that downregulation of endothelial NO synthase (eNOS) expression and activity is likely to contribute to this increase in blood pressure. In the present study, we tested the effects of dexamethasone on the vasodilation of microvascular arterioles using implanted dorsal skin-fold chambers in anesthetized C57BL/6J mice. Experiments were performed on control mice or on mice treated with dexamethasone (0.1-3 mg/kg of body wt). Endothelium-dependent vasodilation in response to ACh (0.1-10 microM) was reduced by dexamethasone in a dose-dependent fashion. Comparable inhibition was seen in tissues superfused with 30 microM N(G)-nitro-L-arginine methyl ester. In contrast, endothelium-independent vasodilation in response to S-nitroso-N-acetyl-D,L-penicillamine (10 microM) was not influenced by either dexamethasone or N(G)-nitro-L-arginine methyl ester. Levels of eNOS mRNA in murine hearts and NO(2)(-)/NO(3)(-) in serum were suppressed by dexamethasone (down to 63 and 50% of control values, respectively, at 3 mg/kg of body wt) along with a reduction in eNOS protein to 85.6%. Dexamethasone also concentration dependently reduced the expression of the cationic amino acid transporter-1 in murine hearts and cultured endothelial cells. The suppression by dexamethasone of the ACh-induced vasodilation could be partially reversed by dietary L-arginine (50 mg/kg of body wt) and by dietary vitamin C (10 g/kg of diet). We conclude that suppression by dexamethasone of the endothelium-mediated microvascular vasodilation involves several mechanisms including 1) downregulation of eNOS, 2) downregulation of cationic amino acid transporter-1, and 3) generation of reactive oxygen species. The demonstration that L-arginine and vitamin C can partially offset the effects of dexamethasone on microvascular arterioles suggests the potential clinical usefulness of these agents for the reduction of glucocorticoid-induced hypertension.
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Affiliation(s)
- S C Schäfer
- Department of Pathology, Johannes Gutenberg University, Mainz, Germany
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Activation of the K+ channel BKCa is involved in the relaxing effect of propofol on coronary arteries. Eur J Anaesthesiol 2004. [DOI: 10.1097/00003643-200403000-00012] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Nagakawa T, Yamazaki M, Hatakeyama N, Stekiel TA. The mechanisms of propofol-mediated hyperpolarization of in situ rat mesenteric vascular smooth muscle. Anesth Analg 2003; 97:1639-1645. [PMID: 14633534 DOI: 10.1213/01.ane.0000087043.61777.1f] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
UNLABELLED Previously, we reported that propofol hyperpolarizes vascular smooth muscle (VSM) cells of small arteries and veins. The current study was designed to determine whether propofol-mediated hyperpolarization is the result of specific effects on potassium channels known to exist in VSM and on steps in the intracellular nitric oxide (NO), cyclic guanosine monophosphate (cGMP), and cyclic adenosine monophosphate (cAMP) second messenger pathways. VSM transmembrane potentials (E(m)) were measured in situ in sympathetically denervated, small mesenteric arteries and veins of Sprague-Dawley rats. Effects of propofol on VSM E(m) were determined before and during superfusion with specific inhibitors of VSM calcium-activated (K(Ca)), adenosine triphosphate-sensitive (K(ATP)), voltage-dependent (K(v)), and inward rectifying (K(IR)) potassium channels and with endogenous mediators of vasodilation. Propofol significantly hyperpolarized VSM in small mesenteric vessels. This hyperpolarization was abolished on inhibition of K(Ca) and K(ATP) channel activity and on inhibition of NO and cGMP (but not cAMP). Assuming a close inverse correlation between the magnitude of VSM E(m) and contractile force, these results suggest that propofol induces hyperpolarization and relaxation in denervated, small mesenteric vessels by activation of K(Ca) and K(ATP) channels. Such channel activation may be mediated by activation of NO and cGMP, but not cAMP, second messenger pathways. IMPLICATIONS The results of this study indicate that propofol-mediated hyperpolarization in vascular smooth muscle can be attributed to the activation of calcium-activated, adenosine triphosphate-sensitive potassium channels, the nitric oxide, and cyclic guanosine monophosphate pathways.
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Affiliation(s)
- Tamotsu Nagakawa
- *Department of Anesthesiology, Toyama Medical and Pharmaceutical University, Toyama, Japan, and the †Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, Wisconsin
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Morio Y, Carter EP, Oka M, McMurtry IF. EDHF-mediated vasodilation involves different mechanisms in normotensive and hypertensive rat lungs. Am J Physiol Heart Circ Physiol 2003; 284:H1762-70. [PMID: 12521932 DOI: 10.1152/ajpheart.00831.2002] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The role of endothelium-derived hyperpolarizing factor (EDHF) in regulating the pulmonary circulation and the participation of cytochrome P-450 (CYP450) activity and gap junction intercellular communication in EDHF-mediated pulmonary vasodilation are unclear. We tested whether tonic EDHF activity regulated pulmonary vascular tone and examined the mechanism of EDHF-mediated pulmonary vasodilation induced by thapsigargin in salt solution-perfused normotensive and hypoxia-induced hypertensive rat lungs. After blockade of both cyclooxygenase and nitric oxide synthase, inhibition of EDHF with charybdotoxin plus apamin did not affect either normotensive or hypertensive vascular tone or acute hypoxic vasoconstriction but abolished thapsigargin vasodilation in both groups of lungs. The CYP450 inhibitors 7-ethoxyresorufin and sulfaphenazole and the gap junction inhibitor palmitoleic acid, but not 18alpha-glycyrrhetinic acid, inhibited thapsigargin vasodilation in normotensive lungs. None of these agents inhibited the vasodilation in hypertensive lungs. Thus tonic EDHF activity does not regulate either normotensive or hypertensive pulmonary vascular tone or acute hypoxic vasoconstriction. Whereas thapsigargin-induced EDHF-mediated vasodilation in normotensive rat lungs involves CYP450 activity and might act through gap junctions, the mechanism of vasodilation is apparently different in hypertensive lungs.
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Affiliation(s)
- Yoshiteru Morio
- Cardiovascular Pulmonary Research Laboratory, Department of Medicine, University of Colorado Health Sciences Center, 4200 East Ninth Avenue, Denver, CO 80262, USA
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