Article

Experimental model for comparative evaluation of pharmacologically induced vasodilation of arterial wall mechanical properties.

Laboratory of Experimental Cardiovascular Physiology and Anaesthesiology, Faculty of Medicine, Montpellier I University, Nîmes, France.
Journal of Cardiovascular Pharmacology (impact factor: 2.29). 10/2003; 42(3):389-94.
Source: PubMed

ABSTRACT Arterial wall compliance (C) and distensibility coefficient (DC) are key factors of pathologic physiology, especially in arteries less than 2 mm in diameter. The aim of this study was to design an experimental model allowing comparative measurement of C and DC during pharmacologically induced vasodilation on small-diameter arteries. Both femoral arteries were exposed in eight New Zealand White rabbits. Diameter (d) and systolic/diastolic diameter changes (deltad) were measured simultaneously, and C and DC were calculated before and after topical application of 1 mL of 4% papaverine on the right side and topical application of 1 mL of 1% lidocaine on the left side. Diameter measurements were performed by echo tracking with 20-MHz implanted microprobes. After papaverine and lidocaine application, respectively, d increased from 1.36 mm to 2.23 mm (P < 0.0001) and from 1.45 mm to 2.4 mm (P < 0.0001), deltad increased from 0.0568 mm to 0.0571 mm (P = 0.34) and from 0.064 mm to 0.077 mm (P < 0.01), C increased from 5.7 x 10(-3) mm/mm Hg to 6 x 10(-3) mm/mm Hg (P < 0.02) and from 6.23 x 10(-3) mm/mm Hg to 8.49 x 10(-3) mm/mm Hg (P < 0.01), and DC decreased from 4.22 x 10(-3) mm Hg(-1) to 2.61 x 10(-3) mm Hg(-1) (P < 0.0004) and from 4.36 x 10(-3) mm/mm Hg to 3.46 x 10(-3) mm/mm Hg (P < 0.005). Papaverine- and lidocaine-induced changes were significantly different for deltad, C, and DC (P < 0.01). These results suggest that, unlike that with papaverine, lidocaine-induced vasodilation leads the artery up to the nonlinear part of its pressure/diameter relationship, with decreased distensibility contrasting with increased diameter and compliance. Our experimental model may be useful to compare the effects of different vasoactive drugs at different concentrations on the mechanical properties of the arterial wall.

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    Article: Local anesthesia for functional endoscopic sinus surgery employing small volumes of epinephrine-containing solutions of lidocaine produces profound hypotension.
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    ABSTRACT: Local anesthetic containing epinephrine is commonly used in many operations for the main purpose of hemostasis. A randomized, controlled, prospective clinical trial was designed to find out hemodynamic changes after local infiltration of different concentrations and/or different dosages of epinephrine during functional endoscopic sinus surgery (FESS) under general anesthesia. One hundred and eight adult patients undergoing elective FESS under general anesthesia were randomly allocated into four groups. Group I received 2% lidocaine 2 ml with epinephrine (5 microg/ml); group II received 1% lidocaine 4 ml with epinephrine (2.5 microg/ml); group III received 1% lidocaine 4 ml with epinephrine (5 microg/ml); and group IV received 1% lidocaine 4 ml for local infiltration. Heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean arterial pressure (MAP) were monitored continuously in the radial artery and recorded in 6 min: before infiltration (baseline), 0.5, 1, 1.5, 2, 2.5, 3, 3.5, 4, 5, and 6 min after local infiltration. The lowest blood pressure (BP) in this period was also recorded. Significant hemodynamic changes, particularly a decrease in BP (P < 0.001) with a slight increase in HR (P < 0.001) at approximately 1.5 min and an increase in SBP at approximately 3 min (P < 0.01) after local infiltration, were observed in group I, group II and group III compared with the baseline, but not in group IV. No significant hemodynamic differences were observed between group I, group II and group III at the same time points (P > 0.05). Local infiltration of low-dose epinephrine causes temporary significant hemodynamic changes particularly a marked decrease in BP during FESS under general anesthesia.
    Acta Anaesthesiologica Scandinavica 12/2005; 49(10):1471-6. · 2.19 Impact Factor

Keywords

1% lidocaine
 
20-MHz implanted microprobes
 
4% papaverine
 
arterial wall
 
Arterial wall compliance
 
comparative measurement
 
Diameter measurements
 
different vasoactive drugs
 
distensibility coefficient
 
femoral arteries
 
left side
 
lidocaine application
 
lidocaine-induced vasodilation
 
mechanical properties
 
New Zealand White rabbits
 
pathologic physiology
 
pharmacologically induced vasodilation
 
small-diameter arteries
 
systolic/diastolic diameter changes
 
topical application