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The Journal of Thoracic and Cardiovascular Surgery, Vol 99, 1030-1036, Copyright © 1990 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association

ARTICLES

The effect of propranolol on the cerebral electrical response to deep hypothermia and total circulatory arrest in lambs

M Azariades, R Firmin, C Lincoln and S Lennox
Department of Cardiac Surgery, Brompton University, London, England.

Deep hypothermia with total circulatory arrest is an important technique in the surgical treatment of complex congenital heart defects. The effects of propranolol on cerebral electrical activity in lambs undergoing a 90-minute period of circulatory arrest after initial surface cooling to 26 degrees C and subsequent core cooling to 15 degrees C was studied by means of the cerebral function analyzing monitor. Five of the lambs were pretreated with intravenous propranolol 0.2 mg/kg (group I) and five acted as controls (group II). The surface cooling phase was associated with a continuous decrease in mean electroencephalographic voltage +/- standard error, which decreased from 82.8 +/- 11.8 microV at 37 degrees C to 31.6 +/- 2.4 microV at 26 degrees C in the control group compared with 75.0 +/- 7.4 microV and 63.2 +/- 9.2, respectively, in the propranolol group (p less than 0.05). During the rewarming phase, the latency to (1) initial appearance of electrical activity, (2) continuous recording with the cerebral function analyzing monitor, and (3) maximum voltage and frequency recovery was 2.0 +/- 1, 5.9 +/- 4, and 32.4 +/- 8 minutes in the propranolol group, which was significantly (p less than or equal to 0.01) shorter than in the control group (18.4 +/- 3, 38.2 +/- 5, and 111.0 +/- 9 minutes, respectively). These results suggest that pretreatment with propranolol may play an important part in the brain tolerance to deep hypothermia and circulatory arrest.

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