Sha K, Shimokawa M, Ishimaru K, Kawaraguchi Y, Takahashi M, Yanaidani F, Kitaguchi K, Furuya H
Department of Anesthesiology, Nara Medical University, Kashihara.
Masui. 2000 Sep;49(9):981-6.
The differences in hemodynamic effects of amrinone, milrinone and olprinone were evaluated in 46 patients for valvular cardiac surgery after cardiopulmonary bypass (CPB). Patients were randomly allocated to three groups; group A with amrinone infusion (17 patients); group M with milrinone infusion (15 patients); and group O with olprinone infusion (14 patients). Each drug was administrated as a single dose into the venous reservoir of the CPB circuit 15 min prior to the end of emergence from CPB, followed by continuous infusion. Hemodynamic parameters were measured at the time of preCPB (C0), just after the end of CPB (C1), one hour after the termination of CPB (C2) and after the chest closure (C3). Catecholamines were used in order of dopamine, norepinephrine and dobutamine. These doses were modulated to maintain the cardiac index > 3.0 l.min-1.m-2 by each anesthesiologist. Hemodynamic parameters (at C0, C1, C2 and C3) and the doses of cathecholamine (at C1, C2 and C3) were compared among the 3 drugs. The systolic blood pressure in group M was significantly higher than that of group A and group O after chest closure. In group M and A, the systolic blood pressure showed a significant increase after CPB. On the other hand, the systolic blood pressure showed no significant change in group O after CPB. Three drugs showed no significant difference in the dosages of catecholamines used.
在46例接受体外循环(CPB)后行心脏瓣膜手术的患者中,评估了氨力农、米力农和奥普力农的血流动力学效应差异。患者被随机分为三组:A组静脉输注氨力农(17例);M组静脉输注米力农(15例);O组静脉输注奥普力农(14例)。每种药物均在CPB结束前15分钟作为单次剂量注入CPB回路的静脉储血器中,随后持续输注。在CPB前(C0)、CPB结束后即刻(C1)、CPB结束后1小时(C2)和关胸后(C3)测量血流动力学参数。按多巴胺、去甲肾上腺素和多巴酚丁胺的顺序使用儿茶酚胺。每位麻醉医生调整这些药物剂量以维持心脏指数>3.0 l·min⁻¹·m⁻²。比较三种药物之间的血流动力学参数(在C0、C1、C2和C3时)和儿茶酚胺剂量(在C1、C2和C3时)。关胸后,M组的收缩压显著高于A组和O组。在M组和A组中,CPB后收缩压显著升高。另一方面,O组CPB后收缩压无显著变化。三种药物在儿茶酚胺使用剂量上无显著差异。