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阿片类药物对猪冠状动脉血管反应性的影响。

Effects of opioids on vasoresponsiveness of porcine coronary artery.

作者信息

Yamanoue T, Brum J M, Estafanous F G, Ferrario C M, Khairallah P A

机构信息

Division of Anesthesia, Cleveland Clinic Foundation, Ohio.

出版信息

Anesth Analg. 1992 Jun;74(6):889-96. doi: 10.1213/00000539-199206000-00019.

Abstract

Myocardial ischemia during surgery can be caused by coronary vasospasm. Neurohumoral mechanisms are involved in this phenomenon, and various substances have been suggested as possible causes, including acetylcholine, histamine, and norepinephrine. The responses of isolated porcine coronary arteries (from 117 pig hearts) with (E+) and without (E-) endothelium to these agents were investigated in the presence of fentanyl, sufentanil, and morphine. Fentanyl significantly shifted to the right, in a concentration-dependent fashion, the concentration-response curve to acetylcholine. This effect was not different between E+ and E- rings. Neither sufentanil nor morphine altered acetylcholine-induced contraction of porcine coronary arteries. Naloxone did not antagonize the suppressive effect of fentanyl on acetylcholine-induced contraction. The response of porcine coronary arteries to norepinephrine was decreased only at very high concentrations of fentanyl. Neither sufentanil nor morphine altered norepinephrine-induced contraction of porcine coronary arteries. Fentanyl, sufentanil, and morphine had no effect on histamine-induced contraction. We conclude that fentanyl antagonized acetylcholine-induced contraction of porcine coronary arteries. This effect of fentanyl seems to be caused by a direct effect on smooth muscle cells and is not opioid-receptor mediated.

摘要

手术期间的心肌缺血可能由冠状动脉痉挛引起。神经体液机制参与了这一现象,并且多种物质被认为可能是病因,包括乙酰胆碱、组胺和去甲肾上腺素。在芬太尼、舒芬太尼和吗啡存在的情况下,研究了有内皮(E+)和无内皮(E-)的离体猪冠状动脉(取自117个猪心脏)对这些药物的反应。芬太尼使乙酰胆碱的浓度-反应曲线以浓度依赖性方式显著右移。这种效应在E+环和E-环之间没有差异。舒芬太尼和吗啡均未改变乙酰胆碱诱导的猪冠状动脉收缩。纳洛酮不能拮抗芬太尼对乙酰胆碱诱导收缩的抑制作用。仅在非常高浓度的芬太尼作用下,猪冠状动脉对去甲肾上腺素的反应才降低。舒芬太尼和吗啡均未改变去甲肾上腺素诱导的猪冠状动脉收缩。芬太尼、舒芬太尼和吗啡对组胺诱导的收缩没有影响。我们得出结论,芬太尼拮抗乙酰胆碱诱导的猪冠状动脉收缩。芬太尼的这种作用似乎是由对平滑肌细胞的直接作用引起的,而非阿片受体介导。

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