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Phenytoin Improves Hemodynamic Tolerance and Survival after Severe Hypoxia

Department of Anesthesiology, The University of Alabama in Birmingham, Birmingham, Alabama, and the Hospital Militar, Santiago, Chile.

Abstract

Three groups of 12 rabbits each, anesthetized with ketamine (30 mg/kg, intramuscularly) and spontaneously breathing N₂O-O₂, were given intravenous injections of either placebo (group 1), thiopental (TP) (40 mglkg, intravenously; group 2), or phenytoin (PNT) (15 mg/kg, intravenously; group 3). Four minutes later, succinylcholine was given and, while ventilation was controlled with N₂O alone, changes in systolic blood pressure (SBP) and heart rate (HR) were measured. Tachycardia (> 210 beats/min) occurred in groups 1, 2, and 3–111, 107, and 151 sec later, respectively. SBP decreased below 100 ton at 189, 192, and 362 sec, respectively, and below 30 ton 245, 216, and 433 sec after the onset of hypoxia (P < 0.05), respectively. Bradycardia (< 30 beats/min) appeared 248, 219, and 439 sec (P < 0.05), respectively. The onset of severe bradycardia and hypotension was significantly (P < 0.05) delayed by PNT but not by TP. All rabbits in the placebo group died, while 3 and 8 of the animals given TP and PNT, respectively, survived; survival rate was significantly (P < 0.05) increased by PNT but not by TP. Phenytoin appears to sustain cardiovascular function during hypoxia better than thiopental does, but phenytoin may not be more effective than thiopental in increasing survival.

Key Words: HYPOXIA • ANTICONVULSANTS—phenytoin

Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999