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麻醉剂对局部缺氧性肺血管收缩的局部作用。

Local effects of anesthetics on regional hypoxic pulmonary vasoconstriction.

作者信息

Benumof J L, Wahrenbrock E A

出版信息

Anesthesiology. 1975 Nov;43(5):525-32. doi: 10.1097/00000542-197511000-00008.

Abstract

The hypothesis that halogenated anesthetics and N2O locally inhibit hypoxic pulmonary vasoconstriction (HPV) was tested. Selective ventilation of the left lower lobe of the lung with N2 in dogs anesthetized with pentobarbital caused blood flow to the lobe to decrease 55.5 +/- 2.0 per cent and lobar vascular resistance to increase 148 +/- 8 per cent. Responses to hypoxia were remeasured during administration of various MAC multiples of inhalation anesthetics to the left lower lobe and following systemic administration of intravenous anesthetics. Isoflurane and fluorexene progressively inhibited and finally almost extinguished the vasoconstriction response as anesthetic concentration increased to 3 MAC. N2O moderately diminished HPV. Halothane had little, and intravenous anesthetics had no, significant effect on HPV. It is concluded that N2O, isoflurane, and fluroxene locally inhibit regional HPV and via this mechanism may increase total venous admixture.

摘要

对卤化麻醉剂和一氧化二氮(N₂O)可局部抑制低氧性肺血管收缩(HPV)这一假说进行了验证。在用戊巴比妥麻醉的犬中,用氮气对左下肺叶进行选择性通气,导致该肺叶血流减少55.5±2.0%,肺叶血管阻力增加148±8%。在向左下肺叶给予不同最低肺泡有效浓度(MAC)倍数的吸入麻醉剂期间以及静脉注射麻醉剂全身给药后,重新测量对低氧的反应。随着麻醉剂浓度增加至3MAC,异氟烷和氟烯逐步抑制并最终几乎消除血管收缩反应。N₂O适度减弱HPV。氟烷对HPV影响很小,静脉麻醉剂对HPV无显著影响。得出的结论是,N₂O、异氟烷和氟烯可局部抑制局部HPV,并且通过这一机制可能增加总的静脉混合血。

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