M Weitzel1, P Hammels2, C Schorer3, H Klingler3, A Weyland3. 1. Universitätsklinik für Anästhesiologie, Intensivmedizin, Notfallmedizin und Schmerztherapie, Klinikum Oldenburg AöR, Medizinischer Campus Carl von Ossietzky Universität Oldenburg, Rahel-Straus-Straße 10, 26133, Oldenburg, Deutschland. weitzel.marianne@klinikum-oldenburg.de. 2. Klinik für Anästhesiologie und Intensivmedizin, St. Bernhard-Hospital Brake gGmbH, Brake, Deutschland. 3. Universitätsklinik für Anästhesiologie, Intensivmedizin, Notfallmedizin und Schmerztherapie, Klinikum Oldenburg AöR, Medizinischer Campus Carl von Ossietzky Universität Oldenburg, Rahel-Straus-Straße 10, 26133, Oldenburg, Deutschland.
Abstract
BACKGROUND: There is insufficient knowledge about the hemodynamic effects of cafedrine/theodrenaline (caf/theo), a commercially available drug combination, to treat hypotension. METHODS: This prospective observational study investigated the hemodynamic effects of caf/theo on anesthesia-induced hypotension in 20 patients scheduled for elective major abdominal surgery. After induction of total intravenous anesthesia (TIVA) with propofol and remifentanil, a decrease in mean arterial blood pressure (MAP) below 60 mm Hg (n = 12) was treated with 60 mg/3 mg caf/theo. The systemic vascular resistance index (SVRI), cardiac index (CI), global end-diastolic index (GEDI), maximum pressure increase in the aorta (dPmx) and global ejection fraction (GEF) were assessed by transpulmonary thermodilution (PiCCO2-Monitor). RESULTS: The MAP increased by approximately 60% 10 min after administration of caf/theo. The increase in MAP was a result of the simultaneous effects on various cardiovascular determinants. An increase in peripheral resistance (SVRI +42%) and CI (+17%) could be determined. Data further indicated that the increase in CI was a consequence of an increase in both dPmx (+31%) and GEDI (+9%) but the GEF remained constant. CONCLUSION: In anesthesia-induced hypotension caf/theo effectively increased the mean arterial blood pressure by combined effects on preload, contractility, and afterload without altering cardiovascular efficiency.
BACKGROUND: There is insufficient knowledge about the hemodynamic effects of cafedrine/theodrenaline (caf/theo), a commercially available drug combination, to treat hypotension. METHODS: This prospective observational study investigated the hemodynamic effects of caf/theo on anesthesia-induced hypotension in 20 patients scheduled for elective major abdominal surgery. After induction of total intravenous anesthesia (TIVA) with propofol and remifentanil, a decrease in mean arterial blood pressure (MAP) below 60 mm Hg (n = 12) was treated with 60 mg/3 mg caf/theo. The systemic vascular resistance index (SVRI), cardiac index (CI), global end-diastolic index (GEDI), maximum pressure increase in the aorta (dPmx) and global ejection fraction (GEF) were assessed by transpulmonary thermodilution (PiCCO2-Monitor). RESULTS: The MAP increased by approximately 60% 10 min after administration of caf/theo. The increase in MAP was a result of the simultaneous effects on various cardiovascular determinants. An increase in peripheral resistance (SVRI +42%) and CI (+17%) could be determined. Data further indicated that the increase in CI was a consequence of an increase in both dPmx (+31%) and GEDI (+9%) but the GEF remained constant. CONCLUSION: In anesthesia-induced hypotensioncaf/theo effectively increased the mean arterial blood pressure by combined effects on preload, contractility, and afterload without altering cardiovascular efficiency.
Authors: Jilles B Bijker; Wilton A van Klei; Yvonne Vergouwe; Douglas J Eleveld; Leo van Wolfswinkel; Karel G M Moons; Cor J Kalkman Journal: Anesthesiology Date: 2009-12 Impact factor: 7.892
Authors: Benjamin Kloth; Simon Pecha; Eileen Moritz; Yvonne Schneeberger; Klaus-Dieter Söhren; Edzard Schwedhelm; Hermann Reichenspurner; Thomas Eschenhagen; Rainer H Böger; Torsten Christ; Sebastian N Stehr Journal: Front Pharmacol Date: 2017-05-23 Impact factor: 5.810