Negishi H, Kuno M, Yasumoto K, Suzuki T, Hosoyamada A
Department of Anesthesiology, Showa University, School of Medicine, Tokyo.
Masui. 1992 Oct;41(10):1590-7.
The changes in myocardial blood flow and systemic hemodynamics during hypotensive anesthesia with adenosine triphosphate (ATP) or ATP with dipyridamole (0.5 mg.kg-1) were studied in 20 mongrel dogs anesthetized with 0.7% halothane in 100% oxygen. In both groups, mean arterial blood pressure (MAP) was reduced to 60 mmHg by intravenous administration of ATP. During hypotensive anesthesia, coronary blood flow, myocardial blood flow and cardiac index increased significantly in both groups. Lactic acid and uric acid increased significantly during hypotensive anesthesia in the group 1. Heart rate, MAP, systemic vascular resistance and coronary vascular resistance decreased significantly during hypotensive anesthesia in both groups. Mean pulmonary arterial pressure, pulmonary arterial wedge pressure and central venous pressure showed no significant changes in both groups. Base excess in the group 1 increased markedly compared with the group 2. We conclude that pretreatment with dipyridamole can prevent metabolic acidosis that occurs during hypotensive anesthesia induced by ATP.
在20只吸入100%氧气、0.7%氟烷麻醉的杂种犬中,研究了三磷酸腺苷(ATP)或ATP联合双嘧达莫(0.5mg/kg)控制性降压麻醉期间心肌血流和全身血流动力学的变化。两组均通过静脉注射ATP使平均动脉血压(MAP)降至60mmHg。控制性降压麻醉期间,两组的冠状动脉血流量、心肌血流量和心脏指数均显著增加。第1组在控制性降压麻醉期间乳酸和尿酸显著增加。两组在控制性降压麻醉期间心率、MAP、全身血管阻力和冠状动脉血管阻力均显著降低。两组的平均肺动脉压、肺动脉楔压和中心静脉压均无显著变化。与第2组相比,第1组的碱剩余显著增加。我们得出结论,双嘧达莫预处理可预防ATP诱导的控制性降压麻醉期间发生的代谢性酸中毒。