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清醒犬及氟烷麻醉期间的心肌功能与代谢

Myocardial function and metabolism in the conscious dog and during halothane anesthesia.

作者信息

Merin R G, Kumazawa T, Luka N L

出版信息

Anesthesiology. 1976 May;44(5):402-15. doi: 10.1097/00000542-197605000-00009.

Abstract

Chronically catheterized dogs were studied awake and during anesthesia with high and low concentrations of halothane to assess the relationship between cardiac function and metabolism. Low concentrations of halothane (0.79 per cent endtidal) increased heart rate and decreased left ventricular stroke volume, stroke work, and dP/dt without producing other hemodynamic changes. However, similar heart rate increases produced by atrial pacing in awake animals increased aortic pressure and cardiac output and decreased left atrial pressure. Consequently, the halothane-induced tachycardia partially compensated for the negative inotropic effect of the halothane. High concentrations of halothane (1.74 per cent endtidal) further increased heart rate and elevated left atrial pressures. Cardiac output, stroke volume, stroke work, aortic pressure, LV dP/dt, myocardial blood flow and oxygen consumption were markedly decreased. Myocardial glucose extraction was also decreased. Myocardial oxygen extraction was unchanged, and lactate extraction rose with both concentrations of halothane. Consequently, the dose-dependent negative inotropic effect of halothane resulted in a decrease in cardiac oxygen demand which was equal to or greater than the decrease in oxygen delivery. Whether the same relationship would be seen in the ischemic heart is yet to be demonstrated.

摘要

对长期留置导管的犬在清醒状态以及使用高、低浓度氟烷麻醉期间进行研究,以评估心脏功能与代谢之间的关系。低浓度氟烷(呼气末浓度为0.79%)可使心率增加,左心室每搏输出量、每搏功和dP/dt降低,且未产生其他血流动力学变化。然而,清醒动物通过心房起搏产生的类似心率增加会使主动脉压和心输出量增加,左心房压降低。因此,氟烷诱导的心动过速部分抵消了氟烷的负性肌力作用。高浓度氟烷(呼气末浓度为1.74%)进一步使心率增加,左心房压升高。心输出量、每搏输出量、每搏功、主动脉压、左心室dP/dt、心肌血流量和氧耗量均显著降低。心肌葡萄糖摄取也降低。心肌氧摄取无变化,两种浓度氟烷均使乳酸摄取增加。因此,氟烷剂量依赖性的负性肌力作用导致心脏氧需求减少,其减少程度等于或大于氧输送的减少程度。在缺血性心脏中是否会出现相同的关系尚待证实。

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