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Epinephrine-Induced Arrhythmias

Effect of Exogenous Prostaglandins and Prostaglandin Synthesis Inhibition during Halothane-O₂ Anesthesia in the Dog

Nathan Leon Pace, MD^*, Akito Ohmura, MD^*, and K. C. Wong, MD, PhD

Department of Anesthesiology, University of Utah College of Medicine, 50 North Medical Drive, Salt Lake City, Utah 84132.

Abstract

Prostaglandins (PG) modify sympathetic and parasympathetic neurotransmission and have antiarrhythmic properties. Inhibitors of PG synthesis sensitize the heart to certain experimentally induced arrhythmias. This study examined the arrhythmogenic dose (AD) of epinephrine n dogs during halothane-O₂ anesthesia as modified by the infusion of PG and by treatment with an inhibitor of PG synthesis.

Dogs were anesthetized with 1.25 MAC halothane. The AD of epinephrine was established by a series of 3-minute epinephrine infusions at 10-minute intervals. The AD of epinephrine was then redetermined during infusions of PG (PGE₁—1 µg/kg/min and PGF₂ alpha—1 µg/ kg/min), after indomethacin, 3 mg/kg, and after aminophylline, 10 mg/kg. The AD remained unchanged from control during both of the PG infusions and following indomethacin. Only Following aminophylline did the AD decrease significantly.

Our study suggests that pretreatment of surgical patients with nonsteroidal antiinflammatory drugs which inhibit PG synthesis does not increase the likelihood of ventricular arrhythmias during halothane-O₂ anesthesia.

Key Words: HORMONES: prostaglandins • HEART: arrhythmias • ANESTHETICS, Volatile: halothane

Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999