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BJA Advance Access originally published online on July 9, 2004
British Journal of Anaesthesia 2004 93(3):414-421; doi:10.1093/bja/aeh215
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© The Board of Management and Trustees of the British Journal of Anaesthesia 2004

Comparative effects of thiopental and propofol on atrial vulnerability: electrophysiological study in a porcine model including acute alcoholic intoxication{dagger}

M. Zaballos1,*, J. Almendral2, M. J. Anadón3, P. González4 and J. Navia1

1 Department of Anesthesiology and 2 Department of Cardiology, Hospital Universitario Gregorio Marañón, Madrid, Spain. 3 Department of Toxicology, Universidad Complutense, Madrid, Spain. 4 Department of Research, Hospital Clínico San Carlos, Madrid, Spain.

* Corresponding author. E-mail: alma{at}nacom.es

Background. Atrial tachyarrhythmias (AT) frequently complicate the perioperative period. Alcohol intoxication is a recognized causative factor for dysrrhythmias. We studied the effects of propofol and thiopental on atrial electrophysiology and vulnerability to AT in a closed-chest porcine model in which AT are facilitated by ethanol.

Methods. Thirty-eight pigs were randomly assigned to thiopental (T-group, n=19) or propofol (P-group n=19). All animals were assigned to undergo a right atrial electrical stimulation protocol (RASP) at baseline. Thirty pigs were assigned to undergo additional RASP during ethanol infusion, while the remaining eight were assigned to undergo additional RASP during saline infusion (control group). We analysed effective refractory period (ERP), and intra-atrial conduction interval (ICI) (between atrial sites 4 cm apart), at several cycle lengths (CL).

Results. There were no significant differences at baseline. During ethanol infusion, propofol produced a greater rate-dependent decrease in excitability, manifested by a longer minimum paced CL with 1:1 atrial capture: 145 (11) vs 164 (27) ms in the T- and P-group, respectively (P=0.01). Propofol was associated with a greater rate-related slowing in conduction: difference between ICI at CL of 300 ms and ICI at minimum CL: 30 ms in P-group and 22 ms in T-group (P<0.03). In the P-group we observed a longer duration of induced arrhythmias (145 (131) vs 74 (91) s, P<0.03) and a higher proportion with atrial flutter (AFl) (76 vs 19%, P<0.001).

Conclusions. Propofol in this model was more arrhythmogenic than thiopental, as manifested by a longer duration of induced arrhythmias, particularly AFl.

{dagger} This work has been presented at the 9th Annual Meeting of European Society of Anaesthesiology, 7–10 April 2001, Gothenburg, Sweden.


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