Effects of flunitrazepam on left ventricular performance, coronary haemodynamics and myocardial metabolism in patients with coronary artery disease
Nitenberg, A.; Marty, J.; Blanchet, F.; Zouioueche, S.; Baury, A.; Desmonts, J.M.
British Journal of Anaesthesia 55(12): 1179-1184
1983
ISSN/ISBN: 0007-0912 PMID: 6418185 Document Number: 213988
The effects of flunitrazepam 15 .mu.g/kg on left ventricular (LV) performance, coronary sinus blood flow (CSBF), myocardial O2 uptake and myocardial lactate balance were studied in 9 patients with coronary artery disease undergoing cardiac catheterization. Flunitrazepam produced a decrease in mean aortic pressure (MAP) and in systemic vascular resistance (SVR) with maximal changes from control value observed at 15 min for MAP and at 5 min for SVR. No change in cardiac index occurred. The following changes in variables related to LV performance were observed: a transient increase in heart rate and left ventricular contractility (Vmax); a sustained decrease of left ventricular end-diastolic pressure, maximum at 15 min. Myocardial O2 consumption was decreased at 15 min but CSBF did not change, while total coronary vascular resistance was decreased. Since myocardial lactate extraction was increased and no change in ECG was observed, a coronary steal induced by coronary vasodilatation did not appear to take place.