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Observational Study
[Hemodynamic effects of cafedrine/theodrenaline on anesthesia-induced hypotension].
- M Weitzel, P Hammels, C Schorer, H Klingler, and A Weyland.
- Universitätsklinik für Anästhesiologie, Intensivmedizin, Notfallmedizin und Schmerztherapie, Klinikum Oldenburg AöR, Medizinischer Campus Carl von Ossietzky Universität Oldenburg, Rahel-Straus-Straße 10, 26133, Oldenburg, Deutschland. weitzel.marianne@klinikum-oldenburg.de.
- Anaesthesist. 2018 Oct 1; 67 (10): 766-772.
BackgroundThere is insufficient knowledge about the hemodynamic effects of cafedrine/theodrenaline (caf/theo), a commercially available drug combination, to treat hypotension.MethodsThis prospective observational study investigated the hemodynamic effects of caf/theo on anesthesia-induced hypotension in 20 patients scheduled for elective major abdominal surgery. After induction of total intravenous anesthesia (TIVA) with propofol and remifentanil, a decrease in mean arterial blood pressure (MAP) below 60 mm Hg (n = 12) was treated with 60 mg/3 mg caf/theo. The systemic vascular resistance index (SVRI), cardiac index (CI), global end-diastolic index (GEDI), maximum pressure increase in the aorta (dPmx) and global ejection fraction (GEF) were assessed by transpulmonary thermodilution (PiCCO2-Monitor).ResultsThe MAP increased by approximately 60% 10 min after administration of caf/theo. The increase in MAP was a result of the simultaneous effects on various cardiovascular determinants. An increase in peripheral resistance (SVRI +42%) and CI (+17%) could be determined. Data further indicated that the increase in CI was a consequence of an increase in both dPmx (+31%) and GEDI (+9%) but the GEF remained constant.ConclusionIn anesthesia-induced hypotension caf/theo effectively increased the mean arterial blood pressure by combined effects on preload, contractility, and afterload without altering cardiovascular efficiency.
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