Reyford H, Adnet P J, Tavernier B, Beague S, Ferri J, Krivosic-Horber R M, Haudecoeur G
Laboratoire d'Anesthésie et de Médecine d'Urgence, Faculté de Médecine, Lille, France.
Anesthesiology. 1999 Apr;90(4):1019-25. doi: 10.1097/00000542-199904000-00015.
An increase in masseter muscle tone in response to halothane or succinylcholine anesthesia (or both) can be observed in healthy persons. Thus the authors compared the fiber-type halothane and succinylcholine sensitivities in human masseter and vastus lateralis muscles.
Masseter and vastus lateralis muscle segments were obtained from 13 and 9 healthy persons, respectively. After chemical skinning of a single fiber and loading the sarcoplasmic reticulum with Ca++ 0.16 microM solution, halothane (0.5-4 vol% bubbled in the incubating solution), succinylcholine (0.1 microM to 10 mM), or both sensitivities were defined as the concentration inducing more than 10% of the maximum tension obtained by application of 16 microM Ca++ solution. The myofilament response to Ca++ was studied with and without halothane by observing the isometric tension of skinned masseter fibers challenged with increasing concentrations of Ca++. Muscle fiber type was determined by the difference in strontium-induced tension measurements.
A significant difference in halothane sensitivity was found between type 1 masseter fibers (0.6+/-0.2 vol%; mean +/- SD) versus type 1 (2.7+/-0.6 vol%) and type 2 vastus lateralis muscle (2.5+/-0.4 vol%). Succinylcholine did not induce Ca++ release by the sarcoplasmic reticulum. In the masseter muscle, 0.75 vol% halothane decreased the maximal activated tension by 40% but did not change the Ca++ concentration that yields 50% of the maximal tension.
The very low halothane threshold for Ca++ release from the masseter muscle usually could be counteracted by a direct negative inotropic effect on contractile proteins. However, halothane may increase the sensitivity of the sarcoplasmic reticulum Ca++ release to succinylcholine-induced depolarization, leading to an increase in masseter muscle tone.
在健康个体中可观察到,氟烷或琥珀酰胆碱麻醉(或两者)会引起咬肌肌张力增加。因此,作者比较了人类咬肌和股外侧肌对氟烷和琥珀酰胆碱的纤维类型敏感性。
分别从13名和9名健康个体获取咬肌和股外侧肌节段。对单根纤维进行化学去膜处理并用0.16微摩尔/升的钙离子溶液加载肌浆网后,氟烷(在孵育溶液中鼓泡至0.5 - 4体积%)、琥珀酰胆碱(0.1微摩尔/升至10毫摩尔)或两者的敏感性定义为诱导出超过用16微摩尔/升钙离子溶液施加时所获最大张力10%的浓度。通过观察用递增浓度钙离子刺激的去膜咬肌纤维的等长张力,研究有无氟烷时肌丝对钙离子的反应。通过锶诱导张力测量的差异确定肌纤维类型。
发现1型咬肌纤维(0.6±0.2体积%;平均值±标准差)与1型股外侧肌(2.7±0.6体积%)和2型股外侧肌(2.5±0.4体积%)对氟烷的敏感性存在显著差异。琥珀酰胆碱未诱导肌浆网释放钙离子。在咬肌中,0.75体积%的氟烷使最大激活张力降低40%,但未改变产生最大张力50%时的钙离子浓度。
咬肌中从肌浆网释放钙离子的氟烷阈值极低,通常可被对收缩蛋白的直接负性变力作用抵消。然而,氟烷可能会增加肌浆网钙离子释放对琥珀酰胆碱诱导的去极化的敏感性,导致咬肌肌张力增加。