This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Lecomte, P. Articles by Riou, B. Search for Related Content PubMed PubMed Citation Articles by Lecomte, P. Articles by Riou, B. Related Collections Cardiovascular Mechanisms Heart

---

CARDIOVASCULAR ANESTHESIA

The Coronary and Myocardial Effects of Remifentanil and Sufentanil in the Erythrocyte-Perfused Isolated Rabbit Heart

From the Laboratory of Anesthesiology, Department of Anesthesia and Critical Care and Department of Emergency Medicine and Surgery, Centre Hospitalier Universitaire Pitié-Salpêtrière, Assistance-Publique-Hôpitaux de Paris, Université Pierre et Marie Curie (Paris 6), Paris, France.

Address correspondence and reprint requests to Alexandre Ouattara, MD, Département d’Anesthésie-Réanimation, Hôpital Pitié-Salpêtrière, 47 Boulevard de l’Hôpital, 75651 Paris Cedex 13, France. Address e-mail to alexandre.ouattara{at}psl.aphp.fr.

Remifentanil-induced hypotension may be associated with adverse ischemic myocardial events. Although these events can be easily attributed to a decrease in coronary pressure perfusion, we tested the hypothesis that remifentanil could directly affect coronary vasomotor tone. Therefore, we assessed intrinsic coronary and myocardial in vitro effects of remifentanil on a Langendorff’s rabbit model and compared these effects with those provoked by similar intracoronary concentrations of sufentanil. Under general anesthesia, hearts from New Zealand rabbits were rapidly excised and mounted on an erythrocyte-perfused and isolated heart preparation. The hearts were then exposed to increasing concentrations (10-1000 nM) of either remifentanil (n = 10) or sufentanil (n = 8). Between each concentration, hearts were allowed to return to baseline status. The maximal coronary and myocardial effects of each concentration of both drugs were noted. Baseline values of coronary blood flow and myocardial performances were comparable between groups. Neither remifentanil nor sufentanil induced significant coronary and myocardial effects. These results suggest that myocardial ischemia, which may occur during remifentanil-induced hemodynamic disturbances, especially in cardiac patients, is only related to a decrease in coronary perfusion pressure provoked by peripheral hemodynamic changes.

This article has been cited by other articles:

				E. A. ten Brinke, R. J. Klautz, S. A. Tulner, F. H. Engbers, H. F. Verwey, D. E. Atsma, M. J. Schalij, E. E. van der Wall, J. J. Bax, H. Putter, et al. Haemodynamics and left ventricular function in heart failure patients: Comparison of awake versus intra-operative conditions Eur J Heart Fail, May 1, 2008; 10(5): 467 - 474. [Abstract] [Full Text] [PDF]