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[Is isoflurane a calcium antagonist?]
G A Blaise1, D C Girard, G Caille
1Département d'Anesthésiologie, Université de Montréal, Hôpital Notre-Dame, Montréal, Québec, Canada.
Abstract:
The vasodilating and myocardial depressant effects of isoflurane have been allocated to calcium channel blockade. The present study aimed to test this hypothesis by assessing the effect of isoflurane on the contractile response to potassium stimulation of vascular smooth muscle. Seventy two left anterior descending and circumflex coronary artery rings were removed in twelve dogs and mounted in organ chambers filled with Krebs-Ringer bicarbonate solution and aerated with 95% O2-5% CO2. Rings were pretreated with either 3.8% isoflurane (2.5 MAC in the dog) or 10(-8) mol.l-1 nifedipine, a calcium entry blocker. They were stimulated by addition of 10 to 150 mmol.l-1 potassium chloride. At 70 mmol.l-1 K+, the tension generated by the untreated rings was 119 +/- 4.25% of control, while in the isoflurane treated group the tension was 99 +/- 2.4% of control. In the opposite, the tension was 25 +/- 7.11% in the nifedipine treated rings. Likewise, when isoflurane was added to rings preconstricted with 40 mmol.l-1 potassium chloride, no relaxation occurred, while nifedipine produced relaxation. Isoflurane, unlike nifedipine, had a weak effect on ring tension. The calcium-entry blockade effect of isoflurane appeared weak, dose-dependent and virtually absent at clinical concentrations. Therefore, the vasodilation seen with clinical concentrations of isoflurane is mediated by mechanisms other than calcium-entry blockade.
Insights
Isoflurane
Area of Science:
- Anesthesiology
- Cardiovascular Pharmacology
Background:
- Isoflurane's vasodilating effects are hypothesized to stem from calcium channel blockade.
- This study investigates the mechanism behind isoflurane-induced vasodilation.
Purpose of the Study:
- To test the hypothesis that isoflurane causes vasodilation via calcium channel blockade.
- To assess isoflurane's effect on vascular smooth muscle contraction stimulated by potassium.
Main Methods:
- Canine coronary artery rings were isolated and mounted in organ chambers.
- Rings were pretreated with isoflurane (2.5 MAC) or nifedipine (calcium entry blocker).
- Vascular smooth muscle contraction was induced by potassium chloride stimulation.
Main Results:
- Isoflurane (99% of control tension) showed a weaker effect on potassium-induced contraction than untreated rings (119% of control).
- Nifedipine significantly reduced contraction (25% of control) and induced relaxation.
- Isoflurane demonstrated minimal effect on ring tension and no relaxation at clinical concentrations.
Conclusions:
- Isoflurane's calcium-entry blockade effect is weak and not significant at clinical concentrations.
- Vasodilation observed with clinical isoflurane concentrations is likely mediated by non-calcium channel blockade mechanisms.
- The hypothesis of isoflurane-induced vasodilation via calcium channel blockade is not supported.