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内皮依赖性循环控制——异氟烷与氟烷外周血管效应差异的一种机制。

Endothelium-dependent circulatory control--a mechanism for the differing peripheral vascular effects of isoflurane versus halothane.

作者信息

Greenblatt E P, Loeb A L, Longnecker D E

机构信息

Department of Anesthesia, University of Pennsylvania School of Medicine, Philadelphia 19104-4283.

出版信息

Anesthesiology. 1992 Dec;77(6):1178-85. doi: 10.1097/00000542-199212000-00020.

Abstract

Several studies have suggested that halothane and isoflurane modify responses to endothelium-dependent vasodilators, indicating that the differing circulatory effects of these anesthetics may be, in part, attributable to alterations in endothelial cell control of vascular tone. This study was designed to determine the contribution of endothelium-derived relaxing factor (EDRF/NO) to circulatory control in indomethacin-treated rats anesthetized with equipotent concentrations (1 MAC) of either isoflurane (n = 6) or halothane (n = 8). Using radiolabelled microspheres, systemic and regional hemodynamics were measured in cerebrum, cerebellum, heart, kidney, gastrointestinal tract, spleen, liver, skeletal muscle, skin, ear, and white and brown fat. Cardiac output, mean arterial pressure (MAP), systemic vascular resistance (SVR), regional blood flows, and regional vascular resistances were determined before (control) and after administration of NG-monomethyl-L-arginine (L-NMMA, 100 mg/kg) to inhibit EDRF/NO synthesis, and following L-arginine (300 mg/kg) to reverse the effects of L-NMMA. In both anesthetic groups, L-NMMA decreased cardiac output and increased MAP, SVR, and regional resistances in brain, heart, kidney, spleen, gastrointestinal tract, hepatic artery, skeletal muscle, skin, and white fat. L-arginine returned SVR and MAP to or below control values in both groups, although cardiac output remained decreased. During isoflurane as compared to halothane anesthesia, L-NMMA caused significantly greater increases in blood pressure (54 +/- 7% vs. 24 +/- 2%) and SVR (143 +/- 22% vs. 79 +/- 11%). In addition, rats anesthetized with isoflurane had significantly greater increases in vascular resistance in heart, kidney, gastrointestinal tract, hepatic artery, and skin after L-NMMA than did rats anesthetized with halothane.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

多项研究表明,氟烷和异氟烷会改变对内皮依赖性血管舒张剂的反应,这表明这些麻醉剂不同的循环效应可能部分归因于内皮细胞对血管张力控制的改变。本研究旨在确定内皮源性舒张因子(EDRF/NO)在吲哚美辛处理的大鼠中,对等效浓度(1 MAC)异氟烷(n = 6)或氟烷(n = 8)麻醉下循环控制的贡献。使用放射性微球,测量大脑、小脑、心脏、肾脏、胃肠道、脾脏、肝脏、骨骼肌、皮肤、耳朵以及白色和棕色脂肪的全身和局部血流动力学。在给予NG-单甲基-L-精氨酸(L-NMMA,100 mg/kg)以抑制EDRF/NO合成之前(对照)和之后,以及给予L-精氨酸(300 mg/kg)以逆转L-NMMA的作用之后,测定心输出量、平均动脉压(MAP)、全身血管阻力(SVR)、局部血流量和局部血管阻力。在两个麻醉组中,L-NMMA均降低了心输出量,并增加了MAP、SVR以及大脑、心脏、肾脏、脾脏、胃肠道、肝动脉、骨骼肌、皮肤和白色脂肪的局部阻力。L-精氨酸使两组的SVR和MAP恢复到对照值或低于对照值,尽管心输出量仍降低。与氟烷麻醉相比,异氟烷麻醉期间,L-NMMA导致血压(54±7%对24±2%)和SVR(143±22%对79±11%)显著更大幅度的升高。此外,与氟烷麻醉的大鼠相比,L-NMMA处理后,异氟烷麻醉的大鼠心脏、肾脏、胃肠道、肝动脉和皮肤的血管阻力显著更大幅度的增加。(摘要截断于250字)

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