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Bolus administration of eltanolone, thiopental, or etomidate does not affect systemic vascular resistance during
P Tassani1, K Martin, U Jänicke
1Institute of Anesthesiology, University of Munich, Grosshadern Medical Center, Germany.
Objective:
To discover possible effects on systemic vascular resistance of the anesthetic induction agent eltanolone in comparison with thiopental and etomidate. The measurements were performed during cardiopulmonary bypass to maintain a constant cardiac output (approximately pump flow).
Design:
The patients were prospectively randomized in three groups to receive either eltanolone, thiopental, or etomidate.
Setting:
University hospital as a single center.
Participants:
Seventy-five patients scheduled for elective coronary artery bypass grafting.
Interventions:
The anesthetic induction agents were repeated at the same dosage when cardiopulmonary bypass was instituted. The respective mean dosages were eltanolone, 0.41 +/- 0.1 mg/kg; thiopental, 2.88 +/- 0.62 mg/kg; etomidate, 0.26 +/- 0.06 mg/kg.
Measurements And Main Results:
Systemic vascular resistance was calculated from the mean of a triple measurement (normal pump flow and +/- 20%). Points of measurement were before, and 2 and 5 minutes after injection of the hypnotic agent. None of the injected drugs made a significant change in the systemic vascular resistance. A small (not significant) decrease from 1,295 +/- 296 dyne/s/cm-5 to 1,196 +/- 323 dyne/s/cm-5 (mean +/- SD) was seen in the eltanolone group, whereas the other patients did not show any change during the study period.
Conclusions:
The reason for the significant reduction of the arterial pressure attributed to anesthetic induction by eltanolone may be more a cardiodepressive effect than a direct vasodilation.