Session/Time	Poster/Thu, 4:30 - 6:30 PM
Title	Sympathetic p Adrenoreceptor-Mediated Pulmonary Vasodilation is Preserved During Ketamine Anesthesia
Author	J Fitch, MD; S Davis, MD; PA Murray, PhD
Affiliation	Cleveland Clinic Foundation, Ohio
Introduction	Our laboratory is systemically investigating the effects of general anesthetics on pulmonary vascula r regulation. We have previously demonstrated that the pulmonary vasodilator response to the 0 adrenoreceptor agonist, isoproterenol, is potentiated during isoflurane anesthesia,' whereas desflurane and sevoflurane anesthesia.attenuate the response to isoproterenol.2 Ketamine is a non- barbiturate, intravenous dissociative anesthetic. Ketamine is frequently used in the pediatric population for short-term procedures (e.g. cardiac catheterization), because I preserves airway reflexes and maintains hemodynamic stability. Our goal was to investigate the effects of ketamine on the pulmonary vasodilator response to isoproterenoli compared to the conscious state.
Method	Three mongrel dogs were chronically-instrumentea to measure the left pulmonary v scular-pressure-flow (LPQ)L relationship. LPQ plots were generated by continuousivi measuring the pulmonary vascular pressure gracientl (pulmonary arterial pressure-left atrial pressure:PAP-LAP)l and left pulmonary blood flow during gradual (-I min) inflation of a raulic occluder implanted around the right pulmonary artevy LPQ plots were measured on separate days in thel conscious and ketamine-anesthetized (I mg-kg-'I-min -1, ivl)i states at baseline, during preconstriction of the pulmonary circulation with the thromboxane analogue, U46619 (-0.15ug - kg-1 min-1 , iv) and during the cumulative administr t' ot isoproterenol (0.01 to 0.1 ug kg-1 min-1, iv). Values are presented as means ± SEM.
Result	Compared to the conscious state, ketamine had noi effect on the baseline LPQ relationship. Following U466191 preconstriction, isoproterenol induced dose-dependeni pulmonary vasadilation in the conscious state (Fig.) Following matched U46619 preconstr;ction, the magnitude of the pulmonary vasodilat6r response to isoproterenol was
	conscious state.

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Document created April 12, 1999