Effects of propofol on cardiovascular dynamics and coronary blood flow in geriatric patients. A comparison with etomidate. 1988

R Larsen, and J Rathgeber, and A Bagdahn, and H Lange, and H Rieke
Department of Anaesthetics, University of Göttingen, Federal Republic of Germany.

The cardiovascular and myocardial effects of propofol and etomidate were studied in 20 geriatric patients (age 65-84 years) who underwent major upper abdominal surgery. Ten patients received propofol 1.5 mg/kg for induction of anaesthesia followed by a continuous infusion of 0.1 mg/kg/minute for maintenance; 10 patients received etomidate 18 mg for induction followed by 2.4 mg/minute for maintenance. Vecuronium was used for neuromuscular blockade. Cardiovascular dynamics were recorded in the awake state one minute after induction and 1, 5 and 30 minutes after tracheal intubation; coronary blood flow (argon wash-in) and myocardial oxygen consumption were determined in the awake state and 5 and 30 minutes after intubation. Both anaesthetics decreased systolic, diastolic and mean arterial pressures, heart rate and cardiac index to the same extent. Myocardial blood flow and oxygen consumption were also reduced in both groups due to a reduction in cardiac work. Tracheal intubation produced a marked increase in arterial pressure in the etomidate group, while haemodynamic changes were absent in the propofol group, Myocardial lactate production was not observed in either group 5 or 30 minutes after tracheal intubation.

UI MeSH Term Description Entries
D010100 Oxygen An element with atomic symbol O, atomic number 8, and atomic weight [15.99903; 15.99977]. It is the most abundant element on earth and essential for respiration. Dioxygen,Oxygen-16,Oxygen 16
D010101 Oxygen Consumption The rate at which oxygen is used by a tissue; microliters of oxygen STPD used per milligram of tissue per hour; the rate at which oxygen enters the blood from alveolar gas, equal in the steady state to the consumption of oxygen by tissue metabolism throughout the body. (Stedman, 25th ed, p346) Consumption, Oxygen,Consumptions, Oxygen,Oxygen Consumptions
D010636 Phenols Benzene derivatives that include one or more hydroxyl groups attached to the ring structure.
D003326 Coronary Circulation The circulation of blood through the CORONARY VESSELS of the HEART. Circulation, Coronary
D005045 Etomidate Imidazole derivative anesthetic and hypnotic with little effect on blood gases, ventilation, or the cardiovascular system. It has been proposed as an induction anesthetic. Ethomidate,Hypnomidate,R-26490,Radenarkon,R 26490,R26490
D006439 Hemodynamics The movement and the forces involved in the movement of the blood through the CARDIOVASCULAR SYSTEM. Hemodynamic
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D000369 Aged, 80 and over Persons 80 years of age and older. Oldest Old
D000771 Anesthesia, Intravenous Process of administering an anesthetic through injection directly into the bloodstream. Anesthesias, Intravenous,Intravenous Anesthesia,Intravenous Anesthesias

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