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Ketamine Preserves and Propofol Potentiates Hypoxic Pulmonary Vasoconstriction Compared with the Conscious State in Chronically Instrumented Dogs

 

作者: Masayasu Nakayama,   Paul Murray,  

 

期刊: Anesthesiology  (OVID Available online 1999)
卷期: Volume 91, issue 3  

页码: 760-760

 

ISSN:0003-3022

 

年代: 1999

 

出版商: OVID

 

关键词: Lung;pulmonary circulation;vasomotor tone.

 

数据来源: OVID

 

摘要:

BackgroundThe authors tested the hypothesis that ketamine and propofol anesthesia would alter the magnitude of hypoxic pulmonary vasoconstriction compared with the conscious state. In addition, they assessed the extent to which cyclooxygenase pathway inhibition and adenosine triphosphate–sensitive potassium channel inhibition modulate hypoxic pulmonary vasoconstriction in the conscious state, and whether these pathways are altered during propofol anesthesia.MethodsTwenty conditioned, male mongrel dogs were chronically instrumented to measure the left pulmonary vascular pressure–flow relationship. Pressure–flow plots were measured during normoxia and hypoxia (systemic arterial PO2reduced to about 60 and about 50 mmHg) on separate days in the conscious state, during ketamine anesthesia, and during propofol anesthesia. The effects of indomethacin and glibenclamide on the magnitude of hypoxic pulmonary vasoconstriction were also assessed in the conscious and propofol‐anesthetized states.ResultsNeither ketamine nor propofol had an effect on the baseline pressure–flow relationship during normoxia compared with the conscious state. Hypoxia resulted in stimulus‐dependent pulmonary vasoconstriction (P< 0.01) in the conscious state. Compared with the conscious state, the magnitude of hypoxic pulmonary vasoconstriction was preserved during ketamine but was potentiated (P< 0.01) during propofol anesthesia. Indomethacin enhanced (P< 0.01) hypoxic pulmonary vasoconstriction in both the conscious and propofol‐anesthetized states. In contrast, glibenclamide only enhanced (P< 0.01) hypoxic pulmonary vasoconstriction in the conscious state and had no effect during propofol anesthesia.ConclusionHypoxic pulmonary vasoconstriction is preserved during ketamine anesthesia but is potentiated during propofol anesthesia. The potentiated response during propofol anesthesia appears to be caused by inhibition of adenosine triphosphate–sensitive potassium channel–mediated pulmonary vasodilation.

 

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