Prostaglandin E1 (PGE1) is well known to dilate small vessels in high doses, resulting in blood pressure reduction. Low doses of the agent are used to maintain the blood flow of reperfusion in a free graft with microangiostomy. In this report we studied the influence of low doses of PGE1 on the systemic circulation in 12 patients who underwent free graft reconstructive surgery of the maxillofacial area, between February 2000 and April 2004 at Kyushu University Dental Hospital. The patients were in the ASA physical status I and anesthetized with isoflurane in 50% of nitrous oxide and oxygen. The concentration of the anesthetics was not changed throughout the study. Low doses of PGE1 were infused during and after anastomosis of the small veins in all the patients. We measured the systolic blood pressure (SBP), the diastolic blood pressure (DBP), the pulse pressure (PP) and the heart rate (HR), and calculated the mean blood pressure (MBP) and the rate pressure product (RPP). The blood pressure was measured directly with canulation into the dorsalis pedis artery. The control values of the parameters were the mean of 12 measurements at every 5 minutes before infusion of PGE1 when anastomosis of an artery took place. The infusion started following completion of the artery anastomosis. At about 15 minutes of infusion, the parameters became stable and 12 measurements were made every 5 minutes during the application of the agent and the average was adopted as the value under PGE 1 administration. The infusion rate of PGE1 was 0.0019 to 0.0042 mg/kg/min, which was determined by the surgeons. The small doses of PGE1 significantly decreased the SBP, MBP, DBP and RPP by about 6%, whereas the agent did not change the HR significantly (Student t-test). We further assessed the correlation between the administration rate and the degree of the reduction of each parameter. In this range of infusion rate, no correlation was found between the two subjects (Table 1). In conclusion, low doses of PGE1 slightly decreased the parameters of the systemic circulation but it may safely be used under careful monitoring of the vital signs.
|Number of pages
|Journal of Japanese Dental Society of Anesthesiology
|Published - 2005
All Science Journal Classification (ASJC) codes
- General Dentistry
- Anesthesiology and Pain Medicine