艾司洛尔可减轻犬在硝普钠诱导的低血压期间的肝血流反应。

Esmolol attenuates hepatic blood flow responses during sodium nitroprusside-induced hypotension in dogs.

作者信息

Takeda Shohei, Masuda Rikuo, Kanazawa Tatsuo, Tomaru Teruaki

机构信息

Department of Anesthesiology, Showa University Fujigaoka Hospital, Yokohama, Japan.

出版信息

Can J Anaesth. 2004 Apr;51(4):348-53. doi: 10.1007/BF03018238.

DOI:10.1007/BF03018238

PMID:15064263

Abstract

PURPOSE

The hemodynamic responses secondary to sympathetic suppression by esmolol may alter blood flow to splanchnic organs. We investigated whether esmolol might modify splanchnic organ blood flow responses during sodium nitroprusside (SNP)-induced hypotension in dogs anesthetized with sevoflurane.

METHODS

The control group (n = 10) received SNP (SNP group). The ES25 and ES100 groups (n = 10, each) received SNP combined with esmolol infused at a constant rate of 25 and 100 micro g*kg(-1)*min(-1) during the hypotensive period after a mean arterial pressure (MAP) of 60 mmHg was attained by the infusion of a 0.03% SNP solution, respectively. The renal, hepatic, and pancreatic blood flows (RBF, HBF, and PBF) were measured by using the hydrogen clearance method.

RESULTS

Cardiac index in the SNP group increased (P < 0.01), but in the ES groups it decreased (P < 0.01). Left ventricular dP/dtmax in the SNP group remained unchanged, but in the ES groups it decreased (P < 0.01, each) during the hypotensive period. Except for HBF in the SNP group, the splanchnic blood flow in all groups decreased (P < 0.01, each). The HBF in the ES groups was lower than that in the SNP group (SNP vs ES25, ES100; 70 +/- 1 vs 64 +/- 5, 6 3 +/- 3 mL*min(-1)*100 g(-1)).

CONCLUSIONS

This study shows that the differences in HBF between SNP-induced hypotension with or without esmolol may be due to the changes in cardiac output caused by alterations of cardiac contractility. These findings suggest that a small dose of esmolol may impair the maintenance of HBF during SNP-induced hypotension.

摘要

目的

艾司洛尔抑制交感神经后引起的血流动力学反应可能会改变内脏器官的血流。我们研究了在七氟醚麻醉的犬中，艾司洛尔是否会改变硝普钠（SNP）诱导低血压期间的内脏器官血流反应。

方法

对照组（n = 10）接受SNP（SNP组）。ES25组和ES100组（每组n = 10）在通过输注0.03% SNP溶液使平均动脉压（MAP）达到60 mmHg后的低血压期，分别接受SNP并以25和100 μg·kg⁻¹·min⁻¹的恒定速率输注艾司洛尔。使用氢清除法测量肾、肝和胰腺血流（RBF、HBF和PBF）。

结果

SNP组的心指数增加（P < 0.01），但ES组的心指数降低（P < 0.01）。SNP组左心室dP/dtmax在低血压期保持不变，但ES组降低（每组P < 0.01）。除SNP组的HBF外，所有组的内脏血流均减少（每组P < 0.01）。ES组的HBF低于SNP组（SNP组与ES25组、ES100组比较；70±1 vs 64±5、63±3 mL·min⁻¹·100 g⁻¹）。