J Cardiovasc Ultrasound. 2014 Jun;22(2):58-64. doi: 10.4250/jcu.2014.22.2.58. Epub 2014 Jun 30.
Comparison of the impact of the anesthesia induction using thiopental and propofol on cardiac function for non-cardiac surgery.
Journal of cardiovascular ultrasound
Hyun Suk Yang, Tae-Yop Kim, Seungho Bang, Ga-Yon Yu, Chungsik Oh, Soo-Nyung Kim, Jung-Hyun Yang
Affiliations
Affiliations
- Department of Cardiovascular Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea.
- Department of Anesthesiology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea.
- Department of Cardiovascular Surgery, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea.
- Department of Obstetrics and Gynecology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea.
- Department of General Surgery, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea.
PMID: 25031795
PMCID: PMC4096666 DOI: 10.4250/jcu.2014.22.2.58
Abstract
BACKGROUND: Thiopental and propofol have been widely used for general anesthesia induction, but their impacts on cardiac function have not been well described. A recent study speculated that anesthesia induction using propofol 2 mg/kg transiently reduced left ventricular (LV) contraction by analyzing tissue Doppler-derived imaging (TDI) during induction phase. The purpose of this study was to analyze and to compare the impacts of propofol- and thiopental-induction on LV function.
METHODS: Twenty-four female patients with normal LV function undergoing non-cardiac surgery were randomly administered intravenous bolus thiopental (5 mg/kg, Thiopental-group, n = 12) or propofol (2 mg/kg, Propofol-group, n = 12) for anesthesia-induction. TDI of septal mitral annular velocity during systole (S'), early diastole (e') and atrial contraction (a') were determined by transthoracic echocardiography before and 1, 3, and 5 minutes after thiopental/propofol administration (T0, T1, T2, and T3, respectively).
RESULTS: The bispectral index and systolic blood pressure declined significantly during anesthesia induction in both groups, however, more depressed in Thiopental-group compared with those in Propofol-group at T2 and T3 (all, p < 0.05). Among TDI two parameters demonstrated a significant inter-group difference: the S' in propofol was lower than that in Thiopental-group at T3 (p = 0.002), and a' velocities were persistently lower in Propofol-group, compared with same time values in Thiopental-group (T1, T2, and T3: p = 0.025, 0.007, and 0.009, respectively).
CONCLUSION: Anesthesia induction using propofol revealed a more persistent and profound decline of LV and atrial contraction than that using thiopental. Further studies are needed to understand the clinical implication.
Keywords: Doppler; Echocardiography; Intraoperative; Propofol; Thiopental
References
- Br J Anaesth. 1997 Jun;78(6):642-51 - PubMed
- Ann Card Anaesth. 2011 May-Aug;14(2):127-32 - PubMed
- Acta Anaesthesiol Taiwan. 2006 Mar;44(1):19-23 - PubMed
- Clin Pharmacokinet. 1998 Aug;35(2):95-134 - PubMed
- Acta Anaesthesiol Scand. 2011 Apr;55(4):429-34 - PubMed
- Circulation. 1999 Sep 7;100(10):1043-9 - PubMed
- Anesth Analg. 2005 Sep;101(3):622-628 - PubMed
- Eur Heart J. 2009 Nov;30(22):2769-812 - PubMed
- Br J Anaesth. 1999 Apr;82(4):516-20 - PubMed
- Curr Opin Cardiol. 2002 Sep;17(5):431-42 - PubMed
- J Am Coll Cardiol. 2007 Oct 23;50(17):1707-32 - PubMed
- Anesth Analg. 1992 Mar;74(3):395-405 - PubMed
- Br J Anaesth. 2007 Feb;98(2):183-8 - PubMed
- J Am Coll Cardiol. 2009 Nov 24;54(22):e13-e118 - PubMed
- Anesth Analg. 1984 Mar;63(3):313-8 - PubMed
- J Am Soc Echocardiogr. 2009 Feb;22(2):107-33 - PubMed
- J Am Soc Echocardiogr. 2013 Jul;26(7):727-35 - PubMed
- Semin Cardiothorac Vasc Anesth. 2006 Mar;10(1):43-8 - PubMed
- Anesth Analg. 1991 Jan;72(1):28-35 - PubMed
- AANA J. 2003 Aug;71(4):265-74 - PubMed
- Anaesthesia. 1991 Feb;46(2):99-105 - PubMed
Publication Types