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右美托咪定可调节心血管系统对中枢神经系统升压部位刺激的反应。

Dexmedetomidine modulates cardiovascular responses to stimulation of central nervous system pressor sites.

作者信息

Farber N E, Samso E, Staunton M, Schwabe D, Schmeling W T

机构信息

Department of Anesthesiology, The Medical College of Wisconsin, Milwaukee 53226, USA.

出版信息

Anesth Analg. 1999 Mar;88(3):617-24. doi: 10.1097/00000539-199903000-00029.

Abstract

UNLABELLED

Halothane attenuates the alterations in arterial pressure (BP) and heart rate (HR) produced by central nervous svstem (CNS) stimulation. We examined the effects of the alpha2-adrenergic agonist dexmedetomidine, with and without halothane, on cardiovascular regulation during CNS pressor site stimulation in chronically instrumented cats. Stimuli trains via bipolar stimulating electrodes in the hypothalamus and reticular formation elicited pressor responses. Dexmedetomidine-induced (15 microg/kg PO) bradycardia was greater in the presence of halothane. CNS stimulation increased BP and HR, which were dose-dependently attenuated by halothane (hypothalamic stimulation 71 +/- 9 mm Hg at control, 25 +/- 5 and 15 +/- 3 mm Hg at 1.0% and 1.5% halothane, respectively). Although dexmedetomidine alone did not alter pressor responses, halothane plus dexmedetomidine attenuated pressor responses in a potentially synergistic fashion (hypothalamic stimulation 67 +/- 8 mm Hg at control, 2 +/- 1 and 1 +/- 0.4 mm Hg at 1.0% and 1.5% halothane, respectively). These results suggest differences in the disruptive effects of CNS-mediated cardiovascular responses by halothane and dexmedetomidine, and that dexmedetomidine has an anesthetic-sparing effect on these CNS-mediated cardiovascular control mechanisms, potentiating the depressant effect of halothane.

IMPLICATIONS

A new potential anesthetic adjunct, dexmedetomidine, does not attenuate brain-mediated increases in blood pressure, but the combination of dexmedetomidine and the anesthetic halothane acts to modulate central cardiovascular responses.

摘要

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氟烷可减弱中枢神经系统(CNS)刺激所引起的动脉血压(BP)和心率(HR)变化。我们研究了在慢性植入仪器的猫中,在有或没有氟烷的情况下,α2肾上腺素能激动剂右美托咪定对CNS升压部位刺激期间心血管调节的影响。通过下丘脑和网状结构中的双极刺激电极施加刺激序列可引发升压反应。在有氟烷存在的情况下,右美托咪定诱导的(15微克/千克口服)心动过缓更为明显。CNS刺激可使BP和HR升高,氟烷可使其呈剂量依赖性减弱(下丘脑刺激时,对照组血压为71±9毫米汞柱,1.0%和1.5%氟烷时分别为25±5和15±3毫米汞柱)。虽然单独使用右美托咪定不会改变升压反应,但氟烷加右美托咪定可潜在地以协同方式减弱升压反应(下丘脑刺激时,对照组血压为67±8毫米汞柱,1.0%和1.5%氟烷时分别为2±1和1±0.4毫米汞柱)。这些结果表明氟烷和右美托咪定对CNS介导的心血管反应的破坏作用存在差异,并且右美托咪定对这些CNS介导的心血管控制机制具有麻醉节省作用,可增强氟烷的抑制作用。

启示

一种新的潜在麻醉辅助药物右美托咪定不会减弱脑介导的血压升高,但右美托咪定与麻醉药氟烷联合使用可调节中枢心血管反应。

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