Lejay M, Hanouz J L, Lecarpentier Y, Coriat P, Riou B
Laboratoire d'Anesthésiologie, Département d'Anesthésie-Réanimation, Centre Hospitalier Universitaire Pitié-Salpêtrière, Université Paris VI, France.
Anesth Analg. 1998 Aug;87(2):277-83. doi: 10.1097/00000539-199808000-00008.
Propofol induces cardiovascular depression but without significant effect on intrinsic myocardial contractility in many species. However, its interactions with adrenoceptor stimulation are unknown. We studied the effects of propofol (1 and 10 microg/mL) and its solvent on the inotropic response induced by phenylephrine (10(-8)-10(-4) M) or isoproterenol (10(-8)-10(-4) M) in rat left ventricular papillary muscles in vitro (Krebs-Henseleit solution, 29 degrees C, pH 7.40, calcium 0.5 mM, stimulation frequency 12 pulses/min). We also studied the lusitropic effects in isotonic and isometric conditions. In control groups, phenylephrine (127% +/- 3% of baseline; P < 0.05) and isoproterenol (169% +/- 11% of baseline; P < 0.05) induced a positive inotropic effect. Propofol (10 microg/mL) completely abolished the positive inotropic effect of phenylephrine (100% +/- 3% of baseline; P = not significant). In contrast, at the lowest concentration (1 microg/mL), propofol did not modify the positive inotropic effect of phenylephrine. Propofol did not modify the inotropic effect of isoproterenol. Propofol (10 microg/mL) enhanced the positive lusitropic effect of isoproterenol under low-load (P < 0.05) but not under high-load conditions.
A high concentration of propofol abolished the positive inotropic effect of alpha- but not beta-adrenoceptor stimulation and enhanced the positive lusitropic effect of beta-adrenoceptor stimulation.
丙泊酚可导致心血管抑制,但在许多物种中对心肌内在收缩力无显著影响。然而,其与肾上腺素能受体刺激的相互作用尚不清楚。我们研究了丙泊酚(1和10微克/毫升)及其溶剂对去氧肾上腺素(10⁻⁸ - 10⁻⁴摩尔)或异丙肾上腺素(10⁻⁸ - 10⁻⁴摩尔)在体外大鼠左心室乳头肌中诱导的变力反应的影响(克雷布斯 - 亨塞尔特溶液,29℃,pH 7.40,钙0.5毫摩尔,刺激频率12次脉冲/分钟)。我们还研究了等张和等长条件下的舒张期作用。在对照组中,去氧肾上腺素(基线的127%±3%;P < 0.05)和异丙肾上腺素(基线的169%±11%;P < 0.05)诱导了正性变力作用。丙泊酚(10微克/毫升)完全消除了去氧肾上腺素的正性变力作用(基线的100%±3%;P = 无显著差异)。相比之下,在最低浓度(1微克/毫升)时,丙泊酚未改变去氧肾上腺素的正性变力作用。丙泊酚未改变异丙肾上腺素的变力作用。丙泊酚(10微克/毫升)在低负荷下增强了异丙肾上腺素的正性舒张期作用(P < 0.05),但在高负荷条件下未增强。
高浓度丙泊酚消除了α - 但非β - 肾上腺素能受体刺激的正性变力作用,并增强了β - 肾上腺素能受体刺激的正性舒张期作用。