Inoue Satoki, Kawaguchi Masahiko, Kurehara Koukichi, Sakamoto Takanori, Kishi Katsuyoshi, Einaga Toshi, Kitaguchi Katsuyasu, Furuya Hitoshi
Department of Anesthesiology, Nara Medical University, Nara, Japan.
Crit Care Med. 2002 Aug;30(8):1863-9. doi: 10.1097/00003246-200208000-00032.
Volatile anesthetics have been shown to dilate cerebral vessels. Recent evidence suggests that mild hypothermia can alter vascular reactivity of the cerebral vessels. However, the effect of mild hypothermia on volatile anesthetic-induced vasodilation of cerebral vessels is unknown. In the present study, we investigated the effect of mild hypothermia on pial arteriolar vasodilation induced by isoflurane and sevoflurane in cats.
Prospective, randomized, experimental study with repeated measures.
Investigational animal laboratory.
Forty cats were used for the study of systemic administration of volatile anesthetics, and 22 cats were used for the study of topical administration of volatile anesthetics.
This study was approved by the Animal Experiment Committee of Nara Medical University. Animals were anesthetized with pentobarbital to maintain suppressive electroencephalographic patterns, which were introduced to measure direct effects of anesthetic agents after removing metabolic effects. The cranial window technique, combined with microscopic video recording, was used for the measurement of small (50-100 microm) and large (100-200 microm) pial arteriolar diameter in an experiment. Animals were randomly assigned to either a normothermic (37 degrees C) or a hypothermic group (33 degrees C). Desired temperatures were maintained by using a water blanket. In the first phase of the study, the effect of hypothermia on pial arteriolar vasodilation induced by systemic administration of isoflurane or sevoflurane was assessed. Each cat received isoflurane or sevoflurane at 0.5, 1.0, 1.5, and 2.0 minimum alveolar anesthetic concentrations, and the diameter of pial arterioles was measured. In the second group of animals, the direct effect of isoflurane and sevoflurane on pial vessels was evaluated. The artificial cerebrospinal fluid bubbled with isoflurane or sevoflurane (minimum alveolar anesthetic concentrations of 1 or 3) was topically administered in the cranial window.
Systemic and topical administration of isoflurane and sevoflurane produced significant dilation of both small and large pial arterioles in a dose-dependent manner during normothermia. In the hypothermic group, vasodilation of small pial arterioles by systemic administration of isoflurane and sevoflurane at a high concentration was significantly larger than in the normothermic group (p <.05). Vasodilation of both small and large pial arterioles by topical administration of isoflurane and sevoflurane was significantly greater in the hypothermic group than in the normothermic group (p <.05).
These results suggest that pial arteriolar vasodilation induced by isoflurane and sevoflurane can be enhanced by mild hypothermia in cats anesthetized with pentobarbital.
挥发性麻醉药已被证明可扩张脑血管。最近的证据表明,轻度低温可改变脑血管的血管反应性。然而,轻度低温对挥发性麻醉药引起的脑血管扩张的影响尚不清楚。在本研究中,我们调查了轻度低温对猫吸入异氟烷和七氟烷引起的软脑膜小动脉扩张的影响。
前瞻性、随机、重复测量的实验研究。
实验动物实验室。
40只猫用于挥发性麻醉药全身给药的研究,22只猫用于挥发性麻醉药局部给药的研究。
本研究经奈良医科大学动物实验委员会批准。动物用戊巴比妥麻醉以维持抑制性脑电图模式,引入该模式以在消除代谢影响后测量麻醉剂的直接作用。在实验中,采用颅窗技术结合显微视频记录来测量小(50 - 100微米)和大(100 - 200微米)软脑膜小动脉直径。动物被随机分为正常体温组(37℃)或低温组(33℃)。通过使用水毯维持所需温度。在研究的第一阶段,评估低温对异氟烷或七氟烷全身给药引起的软脑膜小动脉扩张的影响。每只猫接受0.5、1.0、1.5和2.0最低肺泡有效浓度的异氟烷或七氟烷,并测量软脑膜小动脉直径。在第二组动物中,评估异氟烷和七氟烷对软脑膜血管的直接作用。将用异氟烷或七氟烷(最低肺泡有效浓度为1或3)鼓泡的人工脑脊液局部应用于颅窗。
在正常体温期间,异氟烷和七氟烷的全身及局部给药均以剂量依赖方式引起小和大软脑膜小动脉的显著扩张。在低温组中,高浓度异氟烷和七氟烷全身给药引起的小软脑膜小动脉扩张明显大于正常体温组(p <.05)。低温组中,异氟烷和七氟烷局部给药引起的小和大软脑膜小动脉扩张均明显大于正常体温组(p <.05)。
这些结果表明,在戊巴比妥麻醉的猫中,轻度低温可增强异氟烷和七氟烷引起的软脑膜小动脉扩张。