Schulz-Stübner Sebastian
Department of Anesthesia, University of Iowa Hospitals and Clinics, Iowa City.
Anesth Analg. 2005 Dec;101(6):1809-1811. doi: 10.1213/01.ANE.0000184203.52747.7D.
Small-dose theophylline can be a useful alternative in the treatment of bradycardia in patients with spinal cord injury. In this series of three cases, I describe its successful use for this indication. In one case, initiation of theophylline treatment also increased respiratory drive and minute ventilation. A possible mechanism is that theophylline increases the force of contraction of diaphragmatic muscles because of enhancement of calcium uptake through an adenosine-mediated channel. The antibradycardiac effect is probably mediated through one or more different molecular mechanisms, which seem to be mediated by inhibition of phosphodiesterase 3.
小剂量茶碱可作为脊髓损伤患者心动过缓治疗的一种有效替代方法。在这三例病例中，我描述了其在此适应证中的成功应用。在一例病例中，茶碱治疗的开始还增加了呼吸驱动力和分钟通气量。一种可能的机制是，茶碱通过腺苷介导的通道增强钙摄取，从而增加膈肌收缩力。抗心动过缓作用可能是通过一种或多种不同的分子机制介导的，这些机制似乎是由磷酸二酯酶3的抑制介导的。
