Hostname: page-component-586b7cd67f-vdxz6 Total loading time: 0 Render date: 2024-11-24T14:06:26.360Z Has data issue: false hasContentIssue false

Ketamine enantiomers differentially relax isolated coronary artery rings

Published online by Cambridge University Press:  19 April 2005

A. P. Klockgether-Radke
Affiliation:
Georg-August-University of Goettingen, Centre of Anaesthesiology, Emergency and Intensive Care Medicine, Departments of Anaesthesiological Research, Goettingen, Germany
S. Huneck
Affiliation:
Georg-August-University of Goettingen, Centre of Anaesthesiology, Emergency and Intensive Care Medicine, Departments of Anaesthesiological Research, Goettingen, Germany
S. Meyberg
Affiliation:
Georg-August-University of Goettingen, Centre of Anaesthesiology, Emergency and Intensive Care Medicine, Departments of Anaesthesiological Research, Goettingen, Germany
P. Neumann
Affiliation:
Georg-August-University of Goettingen, Centre of Anaesthesiology, Emergency and Intensive Care Medicine, Departments of Anaesthesiological Research, Goettingen, Germany
G. Hellige
Affiliation:
Georg-August-University of Goettingen, Centre of Anaesthesiology, Emergency and Intensive Care Medicine, Departments of Anaesthesiological Research, Goettingen, Germany
Get access

Abstract

Summary

Background and objective: It has been shown that racemic ketamine increases coronary blood flow and that this effect is at least in part due to a direct vasorelaxing effect of this substance. This study was designed to determine whether ketamine might stereoselectively relax isolated porcine coronary arteries.

Methods: Using the model of isolated vessels we studied the effects of S(+) ketamine, R(−) ketamine, and racemic ketamine (5–500 μg mL−1) on artery strips pre-contracted by either potassium chloride (KCl) or prostaglandin F (PGF). To elucidate possible mechanisms of action these experiments were repeated in the presence of one of the following compounds: Nω-nitro-l-arginine (l-NNA), indomethacin, glibenclamide, and tetraethylammonium (TEA) chloride, an inhibitor of the BKCa K+ channel.

Results: Both isoforms and racemic ketamine relaxed isolated coronary arteries in a concentration-dependent manner in concentrations beyond those used in clinical practice. S(+) ketamine exerted the strongest vasorelaxing effect, followed by racemic ketamine and R(−) ketamine. Pretreatment with l-NNA, indomethacin, or glibenclamide did not alter the vasodilating properties of ketamine, whereas TEA chloride significantly attenuated the vasorelaxing effects of all the three forms of ketamine.

Conclusions: Ketamine dilates coronary arteries in vitro when administered in high concentrations. There is a stereoselective difference with a stronger vasorelaxing effect of S(+) ketamine compared to racemic and R(−) ketamine. The impact of TEA chloride suggests that the activation of the BKCa channel may contribute to the vasodilating effect of ketamine.

Type
Original Article
Copyright
2005 European Society of Anaesthesiology

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Domino EF, Chodoff P, Corssen G. Pharmacologic effects of CI-581, a new dissociative anesthetic, in man. Clin Pharmacol Ther 1965; 6: 279291.Google Scholar
Wong DHW, Jenkins LC. An experimental study of the mechanism of action of ketamine on the central nervous system. Can Anaesth Soc J 1974; 21: 5767.Google Scholar
Folts JD, Alfonso S, Rowe GG. Systemic and coronary haemodynamic effects of ketamine in intact anaesthetized and unanaesthetized dogs. Br J Anesth 1975; 47: 686693.Google Scholar
Klockgether-Radke A, Hagemann I, Frerichs A, Majowski K, Hellige G. Influence of high-dose ketamine on the vascular reactivity of human and porcine isolated coronary artery segments. Acta Anaesthesiol Scand 1997; 41: 12001203.Google Scholar
Klockgether-Radke AP, Frerichs A, Hellige G. Ketamine attenuates the contractile response to vasoconstrictors in isolated coronary artery rings. Anaesthesiol Intensivmed Notfallmed Schmerzther 2003; 38: 767771.Google Scholar
Domino EF, Zsigmond EK, Domino LE, Domino KE, Kothary SP, Domino SE. Plasma levels of ketamine and two of its metabolites in surgical patients using a gas chromatographic mass fragmentographic assay. Anesth Analg 1982; 61: 8792.Google Scholar
Akata T, Izumi K, Nakashima M. Mechanisms of direct inhibitory action of ketamine on vascular smooth muscle in mesenteric resistance arteries. Anesthesiology 2001; 95: 452462.Google Scholar
Coughlan MG, Flynn NM, Kenny D, Warltier DC, Kampine JP. Differential relaxant effect of high concentrations of intravenous anesthetics on endothelin-constricted proximal and distal canine coronary arteries. Anesth Analg 1992; 74: 378383.Google Scholar
Fukuda S, Murakawa T, Takeshita H, Toda N. Direct effects of ketamine on isolated canine cerebral and mesenteric arteries. Anesth Analg 1983; 62: 553558.Google Scholar
Taga K, Fukuda S, Nishimura N, Tsukui A, Morioka M, Shimoji K. Effects of thiopental, pentobarbital, and ketamine on endothelin-induced constriction of porcine cerebral arteries. Anesthesiology 1990; 72: 939941.Google Scholar
Wendling WW, Daniels FB, Chen D, Harakal C, Carlsson C. Ketamine directly dilates bovine cerebral arteries by acting as a calcium entry blocker. J Neurosurg Anesthesiol 1994; 6: 186192.Google Scholar
Lee TS, Hou X. Vasoactive effects of ketamine on isolated rabbit pulmonary arteries. Chest 1995; 107: 11521155.Google Scholar
Maruyama K, Maruyama J, Yokochi A, Muneyuki M, Miyasaka K. Vasodilatory effects of ketamine on pulmonary arteries in rats with chronic hypoxic pulmonary hypertension. Anesth Analg 1995; 80: 786792.Google Scholar
Kaye AD, Banister RE, Anwar M, Feng CJ, Kadowitz PF, Nossaman BD. Pulmonary vasodilation by ketamine is mediated in part by L-type calcium channels. Anesth Analg 1998; 87: 956562.Google Scholar
Kaye AD, Banister RE, Fox CJ, Ibrahim IN, Nossaman BD. Analysis of ketamine responses in the pulmonary vascular bed of the cat. Crit Care Med 2000; 28: 10771082.Google Scholar
Kanmura Y, Missiaen L, Casteels R. The effects of ketamine on Ca2+ movements in A7r5 vascular smooth muscle cells. Anesth Analg 1996; 83: 11051109.Google Scholar
Ogawa K, Tanaka S, Murray PA. Inhibitory effects of etomidate and ketamine on endothelium-dependent relaxation in canine pulmonary artery. Anesthesiology 2001; 94: 668677.Google Scholar
Shakunaga K, Kojima S, Jomura K, Shimizu Y, Satone T, Ito Y. Ketamine suppresses the production and release of endothelin 1 from cultured bovine endothelial cells. Anesth Analg 1998; 86: 10981102.Google Scholar
Kanellopoulos A, Lenz G, Mühlbauer B. Stereoselective differences in the vasorelaxing effects of S(+) and R(−) ketamine on rat isolated aorta. Anesthesiology 1998; 88: 718724.Google Scholar
Wendling WW, Chen D, Daniels FB, et al. The effects of N-methyl-d-aspartate agonists and antagonists on isolated bovine cerebral arteries. Anesth Analg 1996; 82: 264268.Google Scholar
White PF, Ham J, Way WL, Trevor AJ. Pharmacology of ketamine isomers in surgical patients. Anesthesiology 1980; 52: 231239.Google Scholar
Sohn JT, Murray PA. Inhibitory effects of etomidate and ketamine on adenosine triphosphate-sensitive potassium channel relaxation in canine pulmonary artery. Anesthesiology 2003; 98: 104113.Google Scholar
Dojo M, Kinoshita H, Iranami H, Nakahata K, Kimoto Y, Hatano Y. Ketamine stereoselectively affects vasorelaxation mediated by ATP-sensitive K(+) channels in the rat aorta. Anesthesiology 2002; 97: 882886.Google Scholar
Nagao T, Vanhoutte PM. Endothelium-derived hyperpolarizing factor and endothelium-dependent relaxation. Am J Respir Cell Mol Biol 1993; 8: 16.Google Scholar
Wallerstedt SM, Törnebrandt K, Bodelsson M. Relaxant effects of propofol on human omental arteries and veins. Br J Anaesth 1998; 80: 655659.CrossRefGoogle Scholar