Iida H, Ohata H, Iida M, Watanabe Y, Dohi S
Department of Anesthesiology and Critical Care Medicine, Gifu University School of Medicine, Gifu City, Japan.
Anesthesiology. 1999 Aug;91(2):479-85. doi: 10.1097/00000542-199908000-00023.
The effects of adrenergic agonists, often used as local anesthetic additives or spinal analgesics, on spinal vessels have not been firmly established. The authors investigated the effects of alpha2- and alpha1-adrenergic agonists on spinal and cerebral pial vessels in vivo.
Pentobarbital-anesthetized dogs (n = 28) were prepared for measurement of spinal pial-vessel diameter in a spinal-window preparation. The authors applied dexmedetomidine, clonidine, phenylephrine, or epinephrine in three different concentrations (0.5, 5.0, and 50 microg/ml; [2.1, 1.9, 2.5, and 2.3] x [10(-6), 10(-5), and 10(-4)] M, respectively) under the window (one drug in each dog) and measured spinal pial arteriolar and venular diameters in a sequential manner. To enable the comparison of their effects on cerebral vessels, the authors also administered these drugs under a cranial window.
On topical administration, each drug constricted spinal pial arterioles in a concentration-dependent manner. Phenylephrine and epinephrine induced a significantly larger arteriolar constriction than dexmedetomidine or clonidine at 5 microg/ml (8%, 11%, 0%, and 1%, respectively). Spinal pial venules tended to be less constricted than arterioles. In cerebral arterioles, greater constrictions were induced by dexmedetomidine and clonidine than those induced by phenylephrine and epinephrine (14%, 8%, 0%, and 1%, respectively). Cerebral pial venules tended to exhibit larger constrictions than cerebral arterioles (unlike in spinal vessels).
Dexmedetomidine and clonidine constricted spinal vessels in a concentration-dependent manner, but such vasoconstrictions were smaller than those induced by phenylephrine and epinephrine.
肾上腺素能激动剂常作为局部麻醉添加剂或脊髓镇痛药使用,但其对脊髓血管的影响尚未完全明确。作者研究了α2和α1肾上腺素能激动剂对活体脊髓和软脑膜血管的影响。
对28只戊巴比妥麻醉的犬进行脊髓窗制备,以测量脊髓软脑膜血管直径。作者在窗口下方应用右美托咪定、可乐定、去氧肾上腺素或肾上腺素三种不同浓度(分别为0.5、5.0和50微克/毫升;[2.1、1.9、2.5和2.3]×[10⁻⁶、10⁻⁵和10⁻⁴]摩尔/升)(每只犬使用一种药物),并依次测量脊髓软脑膜小动脉和小静脉直径。为了比较它们对脑血管的影响,作者还在颅骨窗下给予这些药物。
局部给药时,每种药物均以浓度依赖方式收缩脊髓软脑膜小动脉。在5微克/毫升时,去氧肾上腺素和可乐定引起的小动脉收缩明显小于去氧肾上腺素或可乐定(分别为8%、11%、0%和1%)。脊髓软脑膜小静脉的收缩程度往往小于小动脉。在脑小动脉中,右美托咪定和可乐定引起的收缩大于去氧肾上腺素和肾上腺素引起的收缩(分别为14%、8%、0%和1%)。脑软脑膜小静脉的收缩程度往往大于脑小动脉(与脊髓血管不同)。
右美托咪定和可乐定以浓度依赖方式收缩脊髓血管,但这种血管收缩小于去氧肾上腺素和肾上腺素引起的收缩。