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挥发性麻醉剂在体外对心肌收缩力的差异性抑制:与兴奋-收缩偶联解偶联剂的比较。

Differential depression of myocardial contractility by volatile anesthetics in vitro: comparison with uncouplers of excitation-contraction coupling.

作者信息

Lynch C

机构信息

Department of Anesthesiology, University of Virginia Health Sciences Center, Charlottesville 22908.

出版信息

J Cardiovasc Pharmacol. 1990 Apr;15(4):655-65. doi: 10.1097/00005344-199004000-00019.

Abstract

Depression of rested state contractions (RSCs) and 0.1-0.25 Hz contractions by equianesthetic concentrations of isoflurane (2.5%), halothane (1.5%), and enflurane (3.5%) was studied in guinea pig papillary muscles in which tension development was enhanced by 0.1 microM isoproterenol. In a second series of experiments, an RSC was elicited, followed by a second contraction elicited with stimulus intervals of 300-600 ms. In both types of experiments, the results were similar. Halothane and enflurane depressed rapid initial tension development more than isoflurane. This initial tension development was also selectively depressed by 0.1 microM ryanodine, which specifically decreases Ca2+ release from the sarcoplasmic reticulum (SR). Isoflurane and also enflurane depressed a delayed and late peaking component of tension development, which was very prominent after rest and was depressed by 200 microM procaine or 500 microM benzocaine. Although isoflurane and enflurane were similar to the local anesthetics in depressing late tension, unlike the local anesthetics they prolonged the late phase of tension development as well. The late tension of the RSC is associated with Ca2+, which enters the rested myocyte on depolarization and may be transiently sequestered in the SR before release. Both early initial and late tension development are depressed to a similar degree by application of 10-20 nM nifedipine. These results emphasize the multiple differing actions of the volatile anesthetics on myocardial contractions, with halothane and isoflurane possessing distinct depressant characteristics.

摘要

在豚鼠乳头肌中研究了等效麻醉浓度的异氟烷(2.5%)、氟烷(1.5%)和恩氟烷(3.5%)对静息状态收缩(RSCs)以及0.1 - 0.25 Hz收缩的抑制作用,这些乳头肌的张力发展通过0.1微摩尔异丙肾上腺素得以增强。在第二系列实验中,引发一次RSC,随后以300 - 600毫秒的刺激间隔引发第二次收缩。在这两种类型的实验中,结果相似。氟烷和恩氟烷比异氟烷更能抑制快速的初始张力发展。这种初始张力发展也被0.1微摩尔的雷诺丁选择性抑制,雷诺丁可特异性减少肌浆网(SR)中Ca2 +的释放。异氟烷以及恩氟烷还抑制张力发展的延迟和晚期峰值成分,该成分在静息后非常显著,并且可被200微摩尔普鲁卡因或500微摩尔苯佐卡因抑制。尽管异氟烷和恩氟烷在抑制晚期张力方面与局部麻醉药相似,但与局部麻醉药不同的是,它们也延长了张力发展的晚期阶段。RSC的晚期张力与Ca2 +相关,Ca2 +在去极化时进入静息的心肌细胞,并可能在释放前短暂地被隔离在肌浆网中。应用10 - 20纳摩尔硝苯地平后,早期初始和晚期张力发展均受到相似程度的抑制。这些结果强调了挥发性麻醉药对心肌收缩的多种不同作用,氟烷和异氟烷具有明显不同的抑制特性。

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