Schuster Frank, Schöll Hendrik, Hager Martin, Müller Rainer, Roewer Norbert, Anetseder Martin
Department of Anesthesiology, University of Wuerzburg, Wuerzburg, Germany.
Anesth Analg. 2006 Feb;102(2):468-72. doi: 10.1213/01.ane.0000189553.57833.11.
We hypothesized that IM halothane and caffeine injection increases local lactate concentration dose-dependently in malignant hyperthermia-susceptible (MHS) and nonsusceptible (MHN) pigs and that the hypermetabolic reaction measured by regional distribution of lactate and carbon dioxide is limited to a small muscle volume. Microdialysis probes were placed in the hindlimbs of 7 MHS and 7 MHN pigs and perfused with Ringer's solution. After equilibration, boluses of increasing halothane and caffeine concentrations were injected. For the second hypothesis regarding regional distribution, microdialysis probes were positioned in 7 MHS and 6 MHN pigs at the injection site for halothane and caffeine and at a distance of 10 mm and 25 mm. Lactate was measured in the dialysate by spectrophotometry. In addition, PCO2 was measured in the halothane experiments. Halothane and caffeine increased IM lactate dose-dependently in MHS pigs significantly more than in MHN pigs. Lactate and PCO2 were increased only at the injection site but not at 10 mm and 25 mm distance. MH susceptibility leads to a leftward shift of the dose-response curve for IM lactate after local injection of halothane and caffeine. The increase of lactate and carbon dioxide levels after local MH trigger injection is limited to a small area around the probe.
我们假设，肌肉内注射氟烷和咖啡因会使恶性高热易感（MHS）和非易感（MHN）猪的局部乳酸浓度呈剂量依赖性增加，并且通过乳酸和二氧化碳的区域分布所测得的高代谢反应仅限于小肌肉体积。将微透析探针置于7只MHS猪和7只MHN猪的后肢，并灌注林格氏液。平衡后，注射递增浓度的氟烷和咖啡因推注量。对于关于区域分布的第二个假设，将微透析探针置于7只MHS猪和6只MHN猪体内，分别位于氟烷和咖啡因的注射部位以及距离注射部位10毫米和25毫米处。通过分光光度法测量透析液中的乳酸。此外，在氟烷实验中测量PCO2。氟烷和咖啡因使MHS猪的肌肉内乳酸呈剂量依赖性增加，且显著高于MHN猪。乳酸和PCO2仅在注射部位升高，而在10毫米和25毫米处未升高。恶性高热易感性导致局部注射氟烷和咖啡因后肌肉内乳酸剂量反应曲线向左移动。局部注射恶性高热触发剂后乳酸和二氧化碳水平的升高仅限于探针周围的小区域。
