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BJA Advance Access published online on June 11, 2004
British Journal of Anaesthesia, doi:10.1093/bja/aeh190
© 2004 by The Board of Management and Trustees of the British Journal of Anaesthesia
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Accepted March 12, 2004

Laboratory Investigation

Differential effects of propofol, ketamine, and thiopental anaesthesia on the skeletal muscle microcirculation of normotensive and hypertensive rats in vivo{dagger}

Z. L. Brookes 1*, C. S. Reilly 1, N. J. Brown 1

1 University of Sheffield, Division of Clinical Sciences (South), Academic Anaesthesia Unit and Microcirculation Research Unit, Royal Hallamshire Hospital, Sheffield S10 2JF, UK

* To whom correspondence should be addressed. E-mail: zoe.brookes{at}sheffield.ac.uk.


  Abstract

Background. This study utilized the dorsal microcirculatory chamber (DMC)model to determine differential effects of i.v. propofol, ketamine, and thiopental anaesthesia on the skeletal muscle microcirculation (10-180 µm) of normotensive (Male Wistar Kyoto, WKY) and hypertensive (spontaneously hypertensive Harlan, SHR) rats, importantly, comparing responses to a conscious baseline.

Methods. Three weeks following implantation of the DMC in WKY (n=8) and SHR (n=6) (130 g) 0.25 ml 100 g-1 FITC-BSA (i.v.) was administered and the microcirculation viewed using fluorescent in vivo microscopy for a 30 min baseline (t=0-30 min). This was followed by either propofol, thiopental, ketamine, or saline (i.v. bolus induction over 5 min (t=30-35 min)), then maintenance step-up infusion for 60 min (t=45-105 min), so that animals received all four agents 1 week apart (56 experiments).

Results. Dilation of A3 arterioles (15-30 µm) and V3 venules (20-40 µm) with propofol was greater in SHR (t=95 min, A3 36.7 (12)%, V3 15.5 (2.3)%) than WKY (t=95 min, A3 19.4 (7.4)%, V3 8.0 (2.3)%) (P<0.05). Constriction of A3 with ketamine was greater in SHR (t=95 min, A3 -29.1 (6.4)%) than WKY (A3 -17.5 (8.8)%) (P<0.05). This was accompanied by hypotension with propofol in SHR (-32% decrease in systolic arterial pressure), but not WKY (-6%) and hypertension with ketamine in WKY(-15%) and SHR (-24%) (P<0.05). During thiopental anaesthesia there was dilation of A1 (80-180 µm), A3, and V3 in WKY (P<0.05). Conversely, in SHR dilation of venules (29.2 (8.7)%) was accompanied by constriction of A1 and A3 (t=95 min, A1 -25.1 (5.9)%, A3 -45.2 (3.1)%) (P<0.05).

Conclusion. Within the skeletal muscle microcirculation of hypertensive rats there is enhanced dilation with propofol and constriction with ketamine, associated with exaggerated changes in arterial pressure. Thus, dysfunctional control mechanisms at the level of the microcirculation alter responses to anaesthesia during hypertension.

Keywords: Keywords: anaesthetics i.v., ketamine; anaesthetics i.v., propofol; anaesthetics i.v., thiopental; muscle, skeletal

{dagger}This work has been presented in part at the meetings of Experimental Biology (Orlando, USA, 2002) and European Society of Anaesthesiologists(2002).


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