Modification of the cardiac rhythm by histamine has been appreciated almost since the compound's isolation from ergot by Barger and Dale in 1910. The major arrhythmogenic actions of histamine are an Hi-receptor-mediated slowing of atriovenrricular (AV) conduction and H2-receptor-mediated increases in sinus rate and ventricular automaticity. These actions were elucidated by observing the salutary effects of histamine antagonists on the arrhythmias of anaphylaxis, and by administering exogenous histamine to various cardiac preparations in the presence and absence of histamine antagonists. The ability to record transmembrane action potenrial(s) (TAP) from single cells has permitted the study of electrophysiological mechanisms underlying histamine-induced arrhythmias.

Histamine and cardiac arrhythmias.

To understand the role of histamine in the aetiology and pathogenesis of human diseases reliable data are urgently needed for the histamine content and for the activities of histamine-forming and-inactivating enzymes in human tissues. In order to make a substantial progress toward this aim a tissue-sampling programme during surgical interventions was carefully conceived and conducted. From March 1982 until January 1983 106 tissue specimens were taken from 56 patients who underwent surgery. Only healthy tissues, not injured or oedematous, and without adherent structures were taken by only one surgeon who was interested in this research and experienced in tissue preparation procedures in biochemistry. The times of ‘warm’ ischaemia during the operative procedures were visually estimated, the times between resection of the organs or specimens and deep-freezing of the tissues were precisely recorded.

Histamine content, diamine oxidase activity and histamine methyltransferase activity in human tissues: fact or fictions?

https://epub.uni-regensburg.de/21766/1/lorenz32.pdf

Perioperative uses of histamine antagonists.

Publisher Summary This chapter presents the adverse effects associated with the use of general anesthetics and therapeutic gases. T. L. K. Rao prospectively studied the incidence of reinfarction following general anesthesia in patients with a history of myocardial infarction. Reinfarction occurred in 14 of 733 such patients (1.9%). The incidence of reinfarction was 5.7% and 2.3% in those patients with 0–3 and 4–6 month-old infarction respectively. Weinsberg showed that patients with mild or moderate hypothyroidism did not differ as a group from controls with regard to the outcome of anesthesia and surgery. Alcoholism is undoubtedly a risk factor in anesthesia, the consequences of which may be coped with, provided the anesthetists do not overlook alcohol-induced functional impairments, notably in the liver, manifestations of alcohol withdrawal, and the pathophysiology of alcoholism with regard to the general anesthetic's pharmacological properties.

General anesthetics and therapeutic gases

Histamine Release in Anaesthesia and Surgery: A New Method to Evaluate its Clinical Significance with Several Types of Causal Relationship

A prospective controlled clinical trial was conducted on changes in plasma histamine and catecholamine levels during 5 standard operations. This communication, as the first part of the trial, deals only with the feasibility of such a trial and the changes in plasma histamine levels. Elevated histamine concentrations corresponding to histamine-release responses of greater than 1 ng/ml occurred in 8 of 25 operations. In an explorative analysis these responses were associated with distinct phases of anaesthesia or the surgical procedure. Blood transfusion carried the risk of infusion of "free histamine" into the patient--especially when administered under pressure. Since during operations "free histamine" enters the circulation with a rather high incidence and may cause harmful effects, premedication with H1-+H2-receptor antagonists seems worth consideration.

/pdf/plasma-histamine-levels-in-patients-in-the-course-of-several-29hpr8rkzy.pdf

B. Gerdes

Papers

Plasma histamine levels in patients in the course of several standard operations: influence of anaesthesia, surgical trauma and blood transfusion.