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氟烷和钙通道阻滞剂对房室传导的影响——维拉帕米、地尔硫䓬和硝苯地平的比较研究

Effects of halothane and calcium entry blockers on atrioventricular conduction-a comparative study of verapamil, diltiazem, and nifedipine.

作者信息

Yokota S, Harada K, Takigawa C, Nakamura I, Kemmotsu O

机构信息

Department of Anesthesiology, Hokkaido University School of Medicine, Sapporo, Japan.

出版信息

J Anesth. 1988 Sep 1;2(2):219-26. doi: 10.1007/s0054080020219.

Abstract

The effects of halothane on AV nodal function were evaluated in dogs with verapamil, diltiazem, or nifedipine during atrial pacing using the technique of His-bundle electrocardiography. Fifty-one mongrel dogs were divided into six groups. Anesthesia was induced with ketamine 100 mg im. and thiamylal 25 mg/kg iv. The animals were intubated and mechanically ventilated at normocapneic levels. Anesthesia was maintained with 50% nitrous-oxide in oxygen with pancuronium 2 mg im. Dogs in groups I, III, and V were anesthetized with 0.8% halothane and 50% nitrous-oxide in oxygen. We observed interactions between halothane and intravenous administration of either verapamil 0.1 mg/kg, diltiazem 0.15 mg/kg, or nifedipine 0.01 mg/kg respectively. Dogs in groups II, IV, and VI were administered either verapamil, diltiazem, or nifedipine iv without halothane. There were prolongations of sinus cycle length (SCL) (414 +/- 10 to 542 +/- 19 msec.), atrium-His (AH) interval (73 +/- 3 to 97 +/- 5 msec.), and functional refractory period (FRP) of the AV-node (227 +/- 5 to 260 +/- 5 msec.) in halothane anesthesia in groups I, III, and V. There were more prolongations of these variables after iv administration of verapamil (SCL; 617 +/- 35, AH; 118 +/- 7, FRP of the AV node; 311 +/- 4) and diltiazem (SCL; 554 +/- 19, AH; 118 +/- 12, FRP of the AV node; 283 +/- 12) but no prolongations after nifedipine (SCL; 533 +/- 19, AH; 99 +/- 8, FRP of the AV node; 272 +/- 9). Comparing effects of calcium entry blockers with and without halothane in groups I and II, III and IV, or V and VI, there were additive depressing effects of halothane with either verapamil or diltiazem on AV nodal function. And there is a difference between the effects of nifedipine on SCL with and without halothane.

摘要

在心房起搏期间,采用希氏束心电图技术,在使用维拉帕米、地尔硫䓬或硝苯地平的犬中评估了氟烷对房室结功能的影响。51只杂种犬被分为6组。用100mg氯胺酮肌肉注射和25mg/kg硫喷妥钠静脉注射诱导麻醉。动物进行气管插管并在正常碳酸血症水平下进行机械通气。用含2mg潘库溴铵的50%氧化亚氮和氧气维持麻醉。第I、III和V组的犬用0.8%氟烷和50%氧化亚氮与氧气混合进行麻醉。我们分别观察了氟烷与静脉注射0.1mg/kg维拉帕米、0.15mg/kg地尔硫䓬或0.01mg/kg硝苯地平之间的相互作用。第II、IV和VI组的犬静脉注射维拉帕米、地尔硫䓬或硝苯地平,不使用氟烷。在第I、III和V组的氟烷麻醉中,窦性周期长度(SCL)(从414±10至542±19毫秒)、心房-希氏束(AH)间期(从73±3至97±5毫秒)以及房室结功能不应期(FRP)(从227±5至260±5毫秒)均延长。静脉注射维拉帕米(SCL;617±35,AH;118±7,房室结FRP;311±4)和地尔硫䓬(SCL;554±19,AH;118±12,房室结FRP;283±12)后,这些变量的延长更明显,但硝苯地平注射后未出现延长(SCL;533±19,AH;99±8,房室结FRP;272±9)。比较第I和II组、III和IV组或V和VI组中使用和不使用氟烷时钙通道阻滞剂的作用,氟烷与维拉帕米或地尔硫䓬对房室结功能有相加的抑制作用。并且硝苯地平在使用和不使用氟烷时对SCL的作用存在差异。

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