Abstract Introduction Clonidine, through its agonist action on central α2-adrenoceptors, is increasingly being used to induce sedation in critically ill patients with persistent acidosis and impaired renal function. Since it is also known to exert cardiovascular effects via peripheral α2-adrenoceptors, we compared its vasoconstrictor activity in porcine isolated arteries at different pH, to that produced by noradrenaline. Methods Isometric tension recordings of porcine isolated mesenteric, splenic and renal arteries (2mm internal diameter) were conducted in modified Krebs-Henseleit solution containing 105mM chloride ions maintained at pH 7.2 and 7.4 (modification of bicarbonate and chloride ions with gluconate ions). The potency of clonidine and noradrenaline was assessed by the pD2 (logarithm of concentration causing 50% of maximum response). Results Clonidine elicited concentration-dependent contractions in the renal artery (pD2 - 7.25±0.09 and 7.10±0.10, n=9) and splenic artery (pD2 - 6.81±0.09 and 7.02±0.06, n=8) that were not altered by a reduction in pH from 7.4 to 7.2 (p >0.05 paired Student's t-test). Clonidine failed to elicit consistent responses in the mesenteric artery (< 10% 60mM KCl). In contrast, the maximum response and potency to noradrenaline in the mesenteric artery (226.6±24.6% and pD2 5.43±0.11, n=6) was significantly reduced (p <0.05) by pH 7.2 (174.4±13.3% and pD2 5.13±0.11, n=6). Responses to noradrenaline in the renal and splenic artery were not affected by changes in pH. Conclusion Acidosis impairs the peripheral vascular actions of the non-selective α-adrenoceptor agonist noradrenaline more than those elicited by the selective α2-adrenoceptor agonist clonidine.
Read full abstract