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British Journal of Anaesthesia, 1989, Vol. 63, No. 4 458-464
© 1989 The Board of Management and Trustees of the British Journal of Anaesthesia

research-article

EFFECT OF VERAPAMIL ON CANINE LEFT VENTRICULAR FUNCTION IN THE PRESENCE OF FENTANYL WHEN APICAL BLOOD FLOW IS CRITICALLY LIMITED

JOHAN DIEDERICKS, B.A., M.MED. (ANES.), F.F.A.(S.A.)*,, BRUCE J. LEONE, M.D.{dagger}, DANIEL M. PHILBIN, M.D.{ddagger} and PIERRE FOËX, D.M., D.PHIL., F.F.A.R.C.S.

Nuffield Department of Anaesthetics, Radcliffe Infirmary Oxford OX2 6HE

* Department of Anaesthesiology, University of the Orange Free State, Bloemfontein. South Africa.

{dagger} Department of Anaesthesiology, Duke Durham North Carolina, U.S.A.

{ddagger} Department of Anaesthesiology, Harvard Medical School, Boston, Massachusetts, U.S.A.

Correspondence to J.D. at Oxford.

Instruments were inserted to seven dogs under halothane anaesthesia, to measure global and regional left ventricular function. Anaesthesia was continued with fentanyl (100 µg kg–1 bolus, then 1.5 µg kg–1 min–1). Critical constriction was applied to the left anterior descending coronary artery. Control recordings were made, followed by bolus administration of verapamil 0.08, 0.16 and 0.32 mg kg–1, with recordings 10 min after each bolus. At the highest dose, verapamil decreased systemic arterial pressure, left ventricular dP/dt, stroke volume and systemic vascular resistance, and increased heart rate significantly. Coronary perfusion pressure decreased and, in the presence of critical constriction, coronary flow per beat decreased significantly. In the region with constriction, systolic shortening of myocardium decreased and post-systolic shortening increased significantly with addition of verapamil. The addition of a high dose of verapamil to fentanyl anaesthesia caused reduction in systolic function and development of early diastolic dysfunction in myocardium with critically limited blood supply.


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