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Vol. 289, Issue 2, 712-720, May 1999
2-Adrenoceptor
Agonists Medetomidine and ST-91 in Anesthetized Sheep1
Departments of
Biomedical Sciences and Clinical Studies (W.N.M.),
Ontario Veterinary College, University of Guelph, Guelph, Ontario,
Canada
To test the hypothesis that pulmonary alterations are more important
than hemodynamic changes in
2-agonist-induced hypoxemia in ruminants, the cardiopulmonary effects of incremental doses of
(4-[1-(2,3-dimethylphenyl)ethyl]-1H-imadazole) hydrochloride (medetomidine; 0.5, 1.0, 2.0, and 4 µg/kg) and
2-(2,6-diethylphenylamino)-2-imidazol (ST-91; 1.5, 3.0, 6.0, and
12 µg/kg) were compared in five halothane-anesthetized, ventilated
sheep using a placebo-controlled randomized crossover design. Pulmonary
resistance (RL), dynamic compliance, and tidal volume
changes in transpulmonary pressure (
Ppl) were determined by
pneumotachography, whereas cardiac index (CI), mean pulmonary artery
pressure (Ppa), and pulmonary artery wedge pressure (Ppaw) were
determined using thermodilution and a Swan-Ganz catheter. The most
important finding was the fall in partial pressure of oxygen in
arterial blood (PaO2) after administration of medetomidine at a dose (0.5 µg/kg) 20 times less than the sedative dose. The PaO2 levels decreased to 214 mm Hg as compared with 510 mm
Hg in the placebo-treated group. This decrease in PaO2 was
associated with a decrease in dynamic compliance and an increase in
RL,
Ppl, and the intrapulmonary shunt fraction without
changes in heart rate, CI, mean arterial pressure, pulmonary vascular
resistance, Ppa, or Ppaw. On the other hand, ST-91 only produced
significant changes in PaO2 at the highest dose. After this
dose of ST-91, the decrease in PaO2 was accompanied by a
50% decrease in CI and an increase in mean arterial pressure, Ppa,
Ppaw, and the intrapulmonary shunt fraction without significant
alterations of RL and
Ppl. The study suggests that the
mechanism(s) by which medetomidine and ST-91 produce lower
PaO2 are different and that drug-induced alterations in the
pulmonary system are mainly responsible for the oxygen-lowering effect
of medetomidine.