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학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
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논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2019.1
- 수록면
- 1 - 12 (12page)
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Background: Propofol induced a decline in the left ventricular (LV) systolic performance in non-cardiac surgery. We tested the hypothesis that propofol decreased the LV contractile function by dose dependent manner in cardiac surgery patients. Methods: Anesthesia was maintained with target-controlled infusions of propofol and remifentanil in cardiac surgery patients. With a fixed effect-site concentration (Ce) of remifentanil (20 ng/mL) after sternotomy, the Ce of propofol was adjusted to maintain a Bispectral index of 40–60 (Ce1). Mitral annular Doppler tissue image tracings and other echocardiographic variables, including end-diastolic and end-systolic volumes, stroke volume, and mitral inflow pulse wave Doppler profile at Ce1, were recorded using transesophageal echocardiography. Echocardiographic recordings were repeated after the Ce-values of propofol were doubled and tripled at 10-minute intervals (defined as Ce2 and Ce3, respectively). Serial changes in echocardiographic variables for each Ce of propofol were assessed using generalized linear mixed effect modeling. The pharmacodynamic relationship between the Ce of propofol and peak systolic mitral annular velocity (Sm) was analyzed by logistic regression using non-linear mixed effect modeling (NONMEM). Results: Means of Ce1, Ce2, and Ce3 were 0.8, 1.6, and 2.4 μg/mL, respectively, and their means of Sm (95% confidence interval) were 9.7 (9.3–10.2), 8.7 (8.2–9.1), and 7.5 cm/ sec (7.0–8.0), respectively (P < 0.01). Ce values of propofol and Sm showed a significant inter-correlation and predictability (intercept, 10.8; slope–1.0 in generalized mixed linear modeling; P < 0.01). Ce values producing 10% and 20% decline of Sm with 50%-probability were 1.4 and 2.1 μg/mL, respectively. Conclusion: Propofol reduces LV systolic long-axis performance in a dose-dependent manner. Trial Registration: ClinicalTrials.gov Identifier: NCT01826149
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참고문헌 (34)
참고문헌 신청
Coetzee A / 1989 / Effect of various propofol plasma concentrations on regional myocardial contractility and left ventricular afterload / Anesth Analg 69(4):473~483
Schmidt C / 1999 / Contractility in humans after coronary artery surgery / Anesthesiology 91(1):58~70
Yang HS / 2013 / Impact of propofol anesthesia induction on cardiac function in low-risk patients as measured by intraoperative Doppler tissue imaging / J Am Soc Echocardiogr 26(7):727~735
Bergquist BD / 1996 / Transesophageal echocardiography in myocardial revascularization: I. Accuracy of intraoperative real-time interpretation / Anesth Analg 82(6):1132~1138
Isaaz K / 1989 / Doppler echocardiographic measurement of low velocity motion of the left ventricular posterior wall / Am J Cardiol 64(1):66~75
Schmidt C / 1999 / Contractility in humans after coronary artery surgery / Anesthesiology 91(1):58~70
Yang HS / 2013 / Impact of propofol anesthesia induction on cardiac function in low-risk patients as measured by intraoperative Doppler tissue imaging / J Am Soc Echocardiogr 26(7):727~735
Bergquist BD / 1996 / Transesophageal echocardiography in myocardial revascularization: I. Accuracy of intraoperative real-time interpretation / Anesth Analg 82(6):1132~1138
Isaaz K / 1989 / Doppler echocardiographic measurement of low velocity motion of the left ventricular posterior wall / Am J Cardiol 64(1):66~75
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