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自主通气期间氟烷和七氟醚麻醉的血流动力学及器官血流反应。

Hemodynamic and organ blood flow responses to halothane and sevoflurane anesthesia during spontaneous ventilation.

作者信息

Crawford M W, Lerman J, Saldivia V, Carmichael F J

机构信息

Department of Anesthesia, Hospital for Sick Children, Toronto, Ontario, Canada.

出版信息

Anesth Analg. 1992 Dec;75(6):1000-6. doi: 10.1213/00000539-199212000-00021.

Abstract

This study compared systemic hemodynamic and organ blood flow responses to equipotent concentrations of halothane and sevoflurane during spontaneous ventilation in the rat. The MAC values for halothane and sevoflurane were determined. Cardiac output and organ blood flows were measured using radiolabeled microspheres. Measurements were obtained in awake rats (control values) and at 1.0 MAC halothane or sevoflurane. The MAC values (mean +/- SEM) for halothane and sevoflurane were 1.10% +/- 0.05% and 2.40% +/- 0.05%, respectively. The PaCO2 increased to a similar extent in both groups compared with control values. During halothane anesthesia, heart rate decreased by 12% (P < 0.01), cardiac index by 26% (P < 0.01), and mean arterial blood pressure by 18% (P < 0.01) compared with control values. Stroke volume index and systemic vascular resistance did not change. During sevoflurane anesthesia, hemodynamic variables remained unchanged compared with control values. Coronary blood flow decreased by 21% (P < 0.01) and renal blood flow by 18% (P < 0.01) at 1.0 MAC halothane, whereas both remained unchanged at 1.0 MAC sevoflurane. Cerebral blood flow increased to a greater extent with halothane (63%; P < 0.01) than with sevoflurane (35%; P < 0.05). During halothane anesthesia, hepatic arterial blood flow increased by 48% (P < 0.01), whereas portal tributary blood flow decreased by 28% (P < 0.01). During sevoflurane anesthesia, hepatic arterial blood flow increased by 70% (P < 0.01) without a concomitant reduction in portal tributary blood flow. Total liver blood flow decreased only with halothane (16%; P < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

本研究比较了在大鼠自主通气期间,等效浓度的氟烷和七氟醚对全身血流动力学及器官血流的反应。测定了氟烷和七氟醚的MAC值。使用放射性微球测量心输出量和器官血流量。在清醒大鼠(对照值)以及1.0 MAC氟烷或七氟醚状态下进行测量。氟烷和七氟醚的MAC值(均值±标准误)分别为1.10%±0.05%和2.40%±0.05%。与对照值相比,两组的PaCO₂升高程度相似。在氟烷麻醉期间,与对照值相比,心率降低12%(P<0.01),心脏指数降低26%(P<0.01),平均动脉血压降低18%(P<0.01)。每搏量指数和全身血管阻力未改变。在七氟醚麻醉期间,与对照值相比,血流动力学变量保持不变。在1.0 MAC氟烷时,冠状动脉血流量降低21%(P<0.01),肾血流量降低18%(P<0.01),而在1.0 MAC七氟醚时两者均保持不变。氟烷使脑血流量增加的幅度(63%;P<0.01)大于七氟醚(35%;P<0.05)。在氟烷麻醉期间,肝动脉血流量增加48%(P<0.01),而门静脉分支血流量降低28%(P<0.01)。在七氟醚麻醉期间,肝动脉血流量增加70%(P<0.01),且门静脉分支血流量未随之减少。仅氟烷使肝脏总血流量降低(16%;P<0.05)。(摘要截取自250字)

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