氟烷和异氟烷对侧卧马匹心血管功能的影响。

The effects of halothane and isoflurane on cardiovascular function in laterally recumbent horses.

作者信息

Raisis A L, Blissitt K J, Henley W, Rogers K, Adams V, Young L E

机构信息

Department of Equine Clinical Studies, Animal Health Trust, Lanwades Park, Newmarket, Suffolk, UK.

出版信息

Br J Anaesth. 2005 Sep;95(3):317-25. doi: 10.1093/bja/aei180. Epub 2005 Jun 24.

DOI:10.1093/bja/aei180

PMID:15980042

Abstract

BACKGROUND

Experimental studies in adult horses have shown that general anaesthesia maintained with isoflurane is associated with less depression of cardiovascular function compared with halothane anaesthesia. Adverse effects of intermittent positive-pressure ventilation (IPPV) have also been demonstrated. Nevertheless, the haemodynamic effects of these agents and the effects of differing modes of ventilation have not been assessed during clinical anaesthesia in horses undergoing surgery.

METHODS

The haemodynamic effects of isoflurane or halothane anaesthesia during spontaneous or IPPV were studied non-invasively in 32 laterally recumbent horses undergoing elective surgery. Indices of cardiac function and measurements of femoral arterial blood flow and resistance were recorded using transoesophageal and transcutaneous Doppler echocardiography, respectively. Arterial pressure was measured directly using a facial artery catheter.

RESULTS

Cardiac index (CI) was significantly higher during isoflurane anaesthesia than during halothane anaesthesia and was also higher during spontaneous ventilation with isoflurane. CI decreased significantly over time and an inverse relationship was observed between CI and mean arterial pressure (MAP). Horses with higher MAP had a significantly lower CI. During isoflurane anaesthesia, femoral arterial blood flow was significantly higher in both pelvic limbs compared with halothane anaesthesia, and flow in the lower limb was significantly higher during spontaneous ventilation than during IPPV. No significant change in femoral blood flow was observed over time.

CONCLUSION

The effects of anaesthetics and mode of ventilation on cardiovascular function recorded under surgical conditions in horses are similar to those reported under experimental conditions. However, in contrast with previous experimental studies, CI progressively decreased over time regardless of agent used or mode of ventilation employed.

摘要

背景

成年马的实验研究表明，与氟烷麻醉相比，异氟烷维持的全身麻醉对心血管功能的抑制作用较小。间歇性正压通气（IPPV）的不良反应也已得到证实。然而，在接受手术的马的临床麻醉期间，尚未评估这些药物对血流动力学的影响以及不同通气模式的影响。

方法

对32匹侧卧接受择期手术的马进行非侵入性研究，观察异氟烷或氟烷麻醉在自主呼吸或IPPV期间的血流动力学效应。分别使用经食管和经皮多普勒超声心动图记录心功能指标以及股动脉血流和阻力的测量值。使用面动脉导管直接测量动脉压。

结果

异氟烷麻醉期间的心指数（CI）显著高于氟烷麻醉期间，异氟烷自主呼吸时的CI也更高。CI随时间显著下降，且观察到CI与平均动脉压（MAP）呈负相关。MAP较高的马CI显著较低。在异氟烷麻醉期间，与氟烷麻醉相比，两个后肢的股动脉血流均显著更高，且自主呼吸时下肢的血流显著高于IPPV时。随时间未观察到股血流有显著变化。