Fentanyl, Na-pentobarbital and halothane influence myocardial infarct size

Abstract

We investigated the effects of three anesthetics on the size of myocardial infarction and on blood flow distribution within the myocardial wall. Myocardial infarcts were induced in 34 dogs by ligating a coronary artery for 90 minutes, and permitting reflow for 90 minutes. The anesthetics used were fentanyl, Na-pentobarbital, and halothane. Under halothane the mean blood pressure (BP) during coronary artery ligation was 113 +/- 2/82 +/- 2 mm Hg and the heart rate (HR) was 135 +/- 2/min. Under fentanyl, the BP was 143 +/- 3/91 +/- 2 mm Hg and HR 99 +/- 3/min. Under Na-pentobarbital, BP was 141 +/- 2/104 +/- 2 mm Hg and HR 146 +/- 2/min. A higher mean BP combined with a slower HR, as seen under fentanyl, was associated with the smallest infarct (24 +/- 8%). Low BP and higher HR, as seen under halothane, was associated with the largest infarct (51 +/- 5%). Na-pentobarbital, with a higher BP but also a faster HR, resulted in an infarct size of 32 +/- 5%. We conclude that a higher mean BP combined with a slower HR might favor the preservation of a larger mass of vulnerable myocardial tissue in a totally occluded coronary artery.