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Anesth Analg 2002;94:1207-1211
© 2002 International Anesthesia Research Society

ANESTHETIC PHARMACOLOGY

Propofol Anesthesia Enhances the Pressor Response to Intravenous Ephedrine

Noriaki Kanaya, MD, Hitoshi Satoh, MD, Sumihiko Seki, MD, Masayasu Nakayama, MD, and Akiyoshi Namiki, MD

Department of Anesthesiology, Sapporo Medical University School of Medicine, Sapporo, Japan

Address correspondence and reprint requests to Noriaki Kanaya, MD, Department of Anesthesiology, Sapporo Medical University School of Medicine, S-1, W-16, Chuo-ku, Sapporo 060-8543, Japan. Address e-mail to kanaya{at}sapmed.ac.jp

The induction of anesthesia with propofol is often associated with a decrease in arterial blood pressure (BP). Although vasopressors are sometimes required to reverse the propofol-induced hypotension, little is known about the effect of propofol on these drugs. We studied the effects of propofol and sevoflurane on pressor response to IV ephedrine. Thirty adult patients were randomly assigned to one of two groups. In the Propofol group (n = 15), patients received pro-pofol 2.5 mg/kg IV for induction followed by 100 µg · kg-1 · min-1 IV for maintenance. In the Sevoflurane group (n = 15), anesthesia was induced with sevoflurane 3%–4% in oxygen and maintained with sevoflurane 2% in oxygen. All patients in both groups received ephedrine 0.1 mg/kg IV before and after the anesthetic induction. Ephedrine increased the heart rate significantly (P < 0.05) in awake patients in both study groups. In contrast, there was no increase in heart rate after the ephedrine administration under propofol or sevoflurane anesthesia. In awake patients, transient increases in mean BP were observed after IV ephedrine in both groups. In the Propofol group, 2 min after the administration of ephedrine, mean BP increased 16% ± 10% under anesthesia but increased only 4% ± 6% when the same patients were awake. The magnitudes of the pressor responses to ephedrine during propofol anesthesia were significantly greater (P < 0.05) than during the awake state. However, ephedrine 0.1 mg/kg IV showed no significant increases in BP during sevoflurane anesthesia. We conclude that propofol, not sevoflurane, anesthesia augments the pressor responses to IV ephedrine.

IMPLICATIONS: The effect of anesthetics on vasopressor-mediated cardiovascular effects is poorly understood. We evaluated the pressor response to ephedrine during propofol or sevoflurane anesthesia. Our study suggests that anesthesia-induced hypotension may be easier to reverse with ephedrine during propofol anesthesia than during sevoflurane anesthesia.






Lippincott, Williams & Wilkins 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 HighWire Press
Copyright © 2002 by the International Anesthesia Research Society.