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Anesth Analg 1988; 67:124-130
© 1988 International Anesthesia Research Society
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Esmolol Decreases the Adverse Effects of Acute Coronary Artery Occlusion on Myocardial Metabolism and Regional Myocardial Blood Flow in Dogs

Avner Sidi, MD, and Richard F. Davis, MD

Department of Anesthesiology, University of Florida College of Medicine, Gainesville, Florida.

Abstract

This study was designed to test the hypothesis that ß-adrenergic receptor blockade with esmolol would decrease the hemodynainic and myocardial metabolic impairment produced by left anterior descending coronary artery (LADa) occlusion. Twenty-three anesthetized open-chest dogs underwent direct cannulation of the LADa, its companion vein (LADv), and a distal circumflex vein (CFXv) for blood sampling. All dogs were subjected to two consecutive 15-minute periods of total LADa occlusion; group 1 (n = 11) received an infusion of esmolol (150 µg-kg–1 min–1) during either occlusion period (randomly assigned) and group 2 (n = 12) received no intervention during either occlusion period. One hour of reperfusion was interposed between the two periods of LADa occlusion. Hemodynainic measurements were made and blood was sampled from the aorta, CFXv, LADa, and LADv before and during both periods of LADa occlusion. Without esmolol infusion, LADa occlusion was associated with decreases in stroke index, coronary perfusion pressure, and left ventricular stroke work index; with esmolol infusion these hemodynainic decrements did not occur. During both LADa occlusion periods in both groups, lactate extraction became negative, i.e., there was net lactate production. Despite this, the magnitude of lactate production was less with esmolol than without it. Finally, average endocardial-to-epicardial blood flow ratio in the LAD perfusion area was decreased during each LAD occlusion period except when esmolol was infused, during which the baseline value was maintained. Thus, infusion of esmolol during temporary LADa occlusion preserved certain hemodynamic variables, preserved the ratio of endocardial-to-epicardial blood flow, and decreased the apparent magnitude of lactate production.

Key Words: HEART—coronary blood flow. • SYMPATHETIC NERVOUS SYSTEM, PHARMACOLOGY—esmolol.




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A. Sidi, J. D. Muehlschlegel, D. S. Kirby, and E. B. Lobato
Treatment of ischaemic left ventricular dysfunction with milrinone or dobutamine administered during coronary artery stenosis in the presence of beta blockade in pigs
Br. J. Anaesth., December 1, 2006; 97(6): 799 - 807.
[Abstract] [Full Text] [PDF]


Lippincott, Williams & Wilkins 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 HighWire Press
Copyright © 1988 by the International Anesthesia Research Society.