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Intravenous Anesthetics in the Pulmonary Circulation

  • Chapter
Nitric Oxide and the Regulation of the Peripheral Circulation

Part of the book series: Nitric Oxide in Biology and Medicine ((NOBM,volume 1))

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Abstract

Intravenous anesthetics in either bolus or constant infusion may be used to produce induction or maintenance of anesthesia. Examples of these anesthetics are ultra-short-acting thiobarbiturates, propofol, etomidate, and ketamine. Of the four, propofol and ketamine possess significant pulmonary effects. Propofol, a di-isopropylphenol derivative, has been used for the induction of general anesthesia and is considered to be a short-acting anesthetic agent with a rapid onset of action and rapid elimination (Smith et al. 1994). Propofol initially decreases the respiratory rate and has an immediate temporary hypotensive action secondary to a reduction in total peripheral resistance. Propofol can produce a decrease in the ventilatory response to hypoxia, suggesting the need for supplementary oxygen in all uses of propofol (Smith et al. 1994). Propofol decreases both systemic arterial and pulmonary arterial pressures without causing a significant reduction in cardiac output in normal humans and children with congenital heart disease (Smith et al. 1994; Williams et al. 1994). The decreases in blood pressure associated with propofol are secondary to a reduction in both systemic and pulmonary vascular resistance; however, little if any shunt has been demonstrated (Mendoza et al. 1992).

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Authors
  1. Alan D. Kaye
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  2. Bobby D. Nossaman
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  3. Philip J. Kadowitz
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Editors and Affiliations

  1. Department of Pharmacology, Tulane University Medical Center, New Orleans, LA, 70112-2699, USA

    Philip J. Kadowitz Ph.D.  & Dennis B. McNamara Ph.D.  & 

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Kaye, A.D., Nossaman, B.D., Kadowitz, P.J. (2000). Intravenous Anesthetics in the Pulmonary Circulation. In: Kadowitz, P.J., McNamara, D.B. (eds) Nitric Oxide and the Regulation of the Peripheral Circulation. Nitric Oxide in Biology and Medicine, vol 1. Birkhäuser, Boston, MA. https://doi.org/10.1007/978-1-4612-1326-0_9

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  • DOI: https://doi.org/10.1007/978-1-4612-1326-0_9

  • Publisher Name: Birkhäuser, Boston, MA

  • Print ISBN: 978-1-4612-7095-9

  • Online ISBN: 978-1-4612-1326-0

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