Ephedrine, dopamine, or doubtamine to treat hypotension with propofol during epidural anesthesia
| Autor: | Yasuhiro Yoshimura, Mayumi Takasaki, Tatuma Iwasaki, Toshiharu Kasaba, Masaharu Yamaga |
|---|---|
| Rok vydání: | 2000 |
| Předmět: |
Anesthesia
Epidural Male medicine.medical_specialty Cardiotonic Agents Dopamine Blood Pressure Dopamine agonist Adrenergic Agents Heart Rate Dobutamine Anesthesiology Intubation Intratracheal medicine Humans Vasoconstrictor Agents Anesthetics Local Sympathomimetics Ephedrine Pneumonectomy Propofol Mastectomy Analysis of Variance Chi-Square Distribution business.industry General Medicine Middle Aged Anesthesiology and Pain Medicine Blood pressure Anesthesia Circulatory system Female Hypotension business Anesthetics Intravenous medicine.drug |
| Zdroj: | Canadian Journal of Anesthesia/Journal canadien d'anesthésie. 47:237-241 |
| ISSN: | 1496-8975 0832-610X |
| DOI: | 10.1007/bf03018919 |
| Popis: | To compare the efficacy of ephedrine, dopamine and dobutamine for circulatory support during thoracic epidural anesthesia after anesthetic induction with propofol.Forty patients undergoing lobectomy or mastectomy were divided into four groups of 10: a control group received no vasopressor; an ephedrine group received 5 mg ephedrine when the mean arterial pressure (MAP), measured every 2.5 min, decreased by 10% from baseline; dopamine and dobutamine groups received 5 microg x kg(-1) x min(-1) dopamine or 3 microg x kg(-1) x min(-1) dobutamine from five minutes after epidural injection of local anesthetic to the end of tracheal intubation. Anesthesia was induced with 2 mg x kg(-1) propofol. The MAP and heart rate (HR) were measured at baseline, 20 min after epidural injection, three minutes after propofol, and one minute after tracheal intubation.In the control group, MAP and HR decreased from 86+/-9 mmHg, 74+/-8 bpm to 62+/-9 mm Hg; P0.0001, 60+/-8 bpm; P = 0.0003 after propofol. After tracheal intubation, MAP was restored to (81+/-13 mmHg, 70+/-13 bpm). In the ephedrine, dopamine, and dobutamine groups, MAP and HR remained unchanged during epidural anesthesia and propofol induction. However, after tracheal intubation, MAP and HR increased in the ephedrine (104+/-11 mm Hg; P = 0.004, 87+/-11 bpm; P0.0001) and dobutamine (117+/-13 mm Hg; P = 0.0005, 100+/-11 bpm; P0.0001) groups, but not in the dopamine group compared with baseline.Dopamine is preferable to ephedrine and dobutamine in providing hemodynamic stability during propofol induction and tracheal intubation following epidural anesthesia. |
| Databáze: | OpenAIRE |
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