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Anesth Analg 1992; 75:515-522
© 1992 International Anesthesia Research Society
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Ibuprofen Pretreatment Does Not Prevent Hemodynamic Instability After Cemented Arthroplasty in Dogs

Robert J. Byrick, MD, FRCPC, P. Y. Wong, PhD, J. Brendan Mullen, MD, FRCPC, and Daniel F. Wiggles worth, BSc

Department of Anaesthesia, St. Michael's Hospital; Department of Clinical Biochemistry, The Toronto Hospital; and Department of Pathology, Mt. Sinai Hospital, University of Toronto, Toronto, Ontario, Canada

Abstract

A bilateral cemented arthroplasty (BCA) in anesthetized mongrel dogs creates pulmonary fat and marrow embolism. A transient increase in plasma concentration of 6-keto prostaglandin Fl{alpha} and thromboxane B2 has been associated with hemodynamic instability after BCA. We tested whether intravenous ibuprofen (20 mg/kg) could inhibit prostaglandin production, pulmonary hypertension, and decreased arterial blood pressure in this model. We found a decrease in cardiac output from 3.0 ± 0.5 to 2.2 ± 1.3 L/min (mean ± 1 SD) after BCA with a flow probe placed at thoracotomy around the ascending thoracic aorta. Systemic arterial blood pressure decreased from 140 ± 11 to 100 ± 15 mm Hg (P < 0.0001), and pulmonary artery pressure increased from 17.7 ± 3.3 to 37.1 ± 9.4 mm hg (p < 0.0001). similar hemodynamic changes were noted in 12 dogs without thoracotomy. pretreatment with ibuprofen did not significantly attenuate the acute hemodynamic changes despite inhibiting prostaglandin generation. we conclude that decreased arterial blood pressure after bca is associated with a decrease in cardiac output and that inhibition of prostaglandin production with ibuprofen does not prevent either pulmonary hypertension or systemic hypotension.






Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins and Stanford University Libraries' HighWire Press®. Copyright 1992 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 1992 by the International Anesthesia Research Society.