Comparative Myocardial Depressive Effects of Propofol and Thiopental

Abstract

 

To compare the direct myocardial effects of thiopental and propofol, concentration-contractility curves were determined by using an isolated guinea pig left atrial preparation. Contractility was measured as peak twitch tension, maximum rate of contraction (dT/dt), and maximum rate of relaxation (-dT/dt). Drug concentrations ranged from 56 μM (10 μg/mL) to 2800 μM (500 μg/mL) propofol and 3.8 μM (1 μg/mL) to 190 μM (50 μg/mL) thiopental. Data were fitted to a sigmoidal inhibitory pharmacodynamic model in which an increasing incremental drug concentration is needed to cause a consistent incremental effect. Comparisons were then made of the drug concentrations at which a 50% inhibition in contractility was noted (IC₅₀). To compare drugs on an equi-anesthetic basis, comparisons also were made between IC₅₀ values normalized to anesthetic concentrations needed to produce anesthesia (67.8 μM and 28.1 μM for thiopental and propofol, respectively). Data from seven atrial preparations for thiopental and seven atrial preparations for propofol were analyzed. The IC₅₀ (μM) for peak twitch tension were 20.9 ± 6.3 and 96.6 ± 10.1 (P < 0.05), for dT/dt were 21.1 ± 5.9 and 86.9 ± 8.3 (P < 0.05), and for -dT/dt were 21.0 ± 6.1 and 84.3 ± 9.2 (P < 0.05) for thiopental and propofol, respectively. When the normalized IC₅₀ were compared, the differences between anesthetics became greater. For guinea pig left atria in vitro, thiopental is a more potent myocardial depressant than propofol, especially when compared relative to anesthetic potencies; neither anesthetic preferentially affects peak twitch tension, maximum rate of contraction, or maximum rate of relaxation.

(Anesth Analg 1993;77:324-9)