caa a22 4500 463158245 CHVBK 20180406164740.0 cr unu---uuuuu 170326e20070401xx s 000 0 eng 10.1007/s10286-006-0387-7 doi (NATIONALLICENCE)springer-10.1007/s10286-006-0387-7 Alternative to ganglionic blockade with anticholinergic and alpha-2 receptor agents [Elektronische Daten] [Brad Wilkins, Christiane Hesse, Hans Sviggum, Wayne Nicholson, Thomas Moyer, Michael Joyner, John Eisenach] The ganglionic blocking agent trimethaphan (TMP) is no longer produced. Therefore, a need exists for alternative pharmacological approaches to investigate baroreflex control of the circulation. The aim of the present study was to examine baroreflex-mediated cardiovascular responses during the administration of a muscarinic receptor antagonist (glycopyrrolate; Gly) and a selective alpha-2 receptor agonist (dexmedetomidine; Dex) and to compare responses to ganglionic blockade with TMP. We hypothesized that combined Gly-Dex would inhibit the baroreflex similar to TMP. Ten volunteers participated in two study days and were instrumented with pulse oximeter, nasal cannula, ECG, continuous blood pressure monitoring (Finapres), and I.V. catheter for drug infusions. Each study day consisted of a control condition followed by either combined Gly-Dex or TMP on alternating days. A Valsalva maneuver was performed under each condition with every subject and six subjects received bolus phenylephrine (25μg) during Gly-Dex and TMP. Combined Gly-Dex increased (P<0.05) blood pressure (99±4mmHg) and heart rate (99±3bpm) relative to control condition (BP: 90±2mmHg; HR: 64±3bpm) and TMP infusion decreased (P<0.05) blood pressure (79±3mmHg) while increasing heart rate (88±3bpm). Valsalva maneuver elicited a persistent drop in arterial pressure (no phase IIb recovery) with the absence of a phase IV overshoot during both Gly-Dex and TMP conditions. Phenylephrine increased systolic pressure 34±4mmHg under Gly-Dex and 23±3mmHg with TMP (P<0.05). Heart rate only decreased 1±2bpm during Gly-Dex and 1±1bpm with TMP. Taken together, our results suggest that Gly-Dex is a reasonable alternative to TMP for baroreflex inhibition. Steinkopff Verlag Darmstadt, 2006 autonomic nervous system nationallicence Valsalva's maneuver nationallicence methodology nationallicence ganglionic blocking agents nationallicence blood pressure nationallicence Wilkins Brad Dept. of Anesthesiology, Mayo Clinic, 200 First Street SW, 55905, Rochester, MN, USA aut Hesse Christiane Dept. of Anesthesiology, Mayo Clinic, 200 First Street SW, 55905, Rochester, MN, USA aut Sviggum Hans Dept. of Anesthesiology, Mayo Clinic, 200 First Street SW, 55905, Rochester, MN, USA aut Nicholson Wayne Dept. of Anesthesiology, Mayo Clinic, 200 First Street SW, 55905, Rochester, MN, USA aut Moyer Thomas Dept. of Anesthesiology, Mayo Clinic, 200 First Street SW, 55905, Rochester, MN, USA aut Joyner Michael Dept. of Anesthesiology, Mayo Clinic, 200 First Street SW, 55905, Rochester, MN, USA aut Eisenach John Dept. of Anesthesiology, Mayo Clinic, 200 First Street SW, 55905, Rochester, MN, USA aut Clinical Autonomic Research Steinkopff-Verlag; www.steinkopff.springer.de 17/2(2007-04-01), 77-84 0959-9851 17:2<77 2007 17 10286 https://doi.org/10.1007/s10286-006-0387-7 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s10286-006-0387-7 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Wilkins Brad Dept. of Anesthesiology, Mayo Clinic, 200 First Street SW, 55905, Rochester, MN, USA aut NATIONALLICENCE 700 1- Hesse Christiane Dept. of Anesthesiology, Mayo Clinic, 200 First Street SW, 55905, Rochester, MN, USA aut NATIONALLICENCE 700 1- Sviggum Hans Dept. of Anesthesiology, Mayo Clinic, 200 First Street SW, 55905, Rochester, MN, USA aut NATIONALLICENCE 700 1- Nicholson Wayne Dept. of Anesthesiology, Mayo Clinic, 200 First Street SW, 55905, Rochester, MN, USA aut NATIONALLICENCE 700 1- Moyer Thomas Dept. of Anesthesiology, Mayo Clinic, 200 First Street SW, 55905, Rochester, MN, USA aut NATIONALLICENCE 700 1- Joyner Michael Dept. of Anesthesiology, Mayo Clinic, 200 First Street SW, 55905, Rochester, MN, USA aut NATIONALLICENCE 700 1- Eisenach John Dept. of Anesthesiology, Mayo Clinic, 200 First Street SW, 55905, Rochester, MN, USA aut NATIONALLICENCE 773 0- Clinical Autonomic Research Steinkopff-Verlag; www.steinkopff.springer.de 17/2(2007-04-01), 77-84 0959-9851 17:2<77 2007 17 10286 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer