Hirabayashi Y, Igarashi T, Saitoh K, Fukuda H, Suzuki H, Shimizu R
Department of Anaesthesiology, Jichi Medical School, Tochigi, Japan.
Acta Anaesthesiol Scand. 2000 Oct;44(9):1128-33. doi: 10.1034/j.1399-6576.2000.440916.x.
Increasing evidence indicates that amrinone, a phosphodiesterase fraction III (PDE-III) inhibitor, has relative efficacy as an initial treatment for cardiovascular depression after bupivacaine in an experimental setting. This study was performed to compare the cardiovascular effects of the other new PDE-III inhibitors, milrinone and olprinone, with those of amrinone in reversing bupivacaine-induced cardiovascular depression.
In sevoflurane-anaesthetized dogs, bupivacaine was infused intravenously at 1 mg x kg(-1) x min(-1) until mean arterial pressure fell to 60 mmHg or less. The dogs received either amrinone (2 mg x kg(-1)), milrinone (0.2 mg x kg(-1)), olprinone (0.12 mg x kg(-1)) or 0.9% saline (0.5 ml x kg(-1)).
Amrinone, milrinone and olprinone improved left ventricular systolic and diastolic function, resulting in an increase in cardiac index. The most significant difference observed among the three drugs was the change in heart rate (HR) after treatment. Milrinone significantly increased HR, but olprinone did not.
Milrinone and olprinone are as effective as amrinone in reversing bupivacaine-induced cardiovascular depression.
越来越多的证据表明，氨力农作为一种磷酸二酯酶Ⅲ（PDE-Ⅲ）抑制剂，在实验环境中作为布比卡因所致心血管抑制的初始治疗药物具有相对疗效。本研究旨在比较另外两种新型PDE-Ⅲ抑制剂米力农和奥普力农与氨力农在逆转布比卡因所致心血管抑制方面的心血管效应。
在七氟醚麻醉的犬中，以1mg·kg⁻¹·min⁻¹的速度静脉输注布比卡因，直至平均动脉压降至60mmHg或更低。犬分别接受氨力农（2mg·kg⁻¹）、米力农（0.2mg·kg⁻¹）、奥普力农（0.12mg·kg⁻¹）或0.9%生理盐水（0.5ml·kg⁻¹）。
氨力农、米力农和奥普力农改善了左心室收缩和舒张功能，导致心脏指数增加。三种药物之间观察到的最显著差异是治疗后心率（HR）的变化。米力农显著增加HR，但奥普力农没有。
米力农和奥普力农在逆转布比卡因所致心血管抑制方面与氨力农同样有效。
