Comparison of the Impact of the Anesthesia Induction Using Thiopental and Propofol on Cardiac Function for Non-Cardiac Surgery
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Background: Thiopental and propofol have been widely used for general anesthesia induction, but their impacts on cardiacfunction have not been well described. A recent study speculated that anesthesia induction using propofol 2 mg/kg transientlyreduced left ventricular (LV) contraction by analyzing tissue Doppler-derived imaging (TDI) during induction phase. Thepurpose of this study was to analyze and to compare the impacts of propofol- and thiopental-induction on LV function. Methods: Twenty-four female patients with normal LV function undergoing non-cardiac surgery were randomly administeredintravenous bolus thiopental (5 mg/kg, Thiopental-group, n = 12) or propofol (2 mg/kg, Propofol-group, n = 12) for anesthesiainduction. TDI of septal mitral annular velocity during systole (S’), early diastole (e’) and atrial contraction (a’) were determinedby transthoracic echocardiography before and 1, 3, and 5 minutes after thiopental/propofol administration (T0, T1, T2, and T3,respectively). Results: The bispectral index and systolic blood pressure declined significantly during anesthesia induction in both groups,however, more depressed in Thiopental-group compared with those in Propofol-group at T2 and T3 (all, p < 0.05). Among TDItwo parameters demonstrated a significant inter-group difference: the S’ in propofol was lower than that in Thiopental-group atT3 (p = 0.002), and a’ velocities were persistently lower in Propofol-group, compared with same time values in Thiopental-group(T1, T2, and T3: p = 0.025, 0.007, and 0.009, respectively). Conclusion: Anesthesia induction using propofol revealed a more persistent and profound decline of LV and atrial contractionthan that using thiopental. Further studies are needed to understand the clinical implication.
Abstract
Background: Thiopental and propofol have been widely used for general anesthesia induction, but their impacts on cardiacfunction have not been well described. A recent study speculated that anesthesia induction using propofol 2 mg/kg transientlyreduced left ventricular (LV) contraction by analyzing tissue Doppler-derived imaging (TDI) during induction phase. Thepurpose of this study was to analyze and to compare the impacts of propofol- and thiopental-induction on LV function. Methods: Twenty-four female patients with normal LV function undergoing non-cardiac surgery were randomly administeredintravenous bolus thiopental (5 mg/kg, Thiopental-group, n = 12) or propofol (2 mg/kg, Propofol-group, n = 12) for anesthesiainduction. TDI of septal mitral annular velocity during systole (S’), early diastole (e’) and atrial contraction (a’) were determinedby transthoracic echocardiography before and 1, 3, and 5 minutes after thiopental/propofol administration (T0, T1, T2, and T3,respectively). Results: The bispectral index and systolic blood pressure declined significantly during anesthesia induction in both groups,however, more depressed in Thiopental-group compared with those in Propofol-group at T2 and T3 (all, p < 0.05). Among TDItwo parameters demonstrated a significant inter-group difference: the S’ in propofol was lower than that in Thiopental-group atT3 (p = 0.002), and a’ velocities were persistently lower in Propofol-group, compared with same time values in Thiopental-group(T1, T2, and T3: p = 0.025, 0.007, and 0.009, respectively). Conclusion: Anesthesia induction using propofol revealed a more persistent and profound decline of LV and atrial contractionthan that using thiopental. Further studies are needed to understand the clinical implication.
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