Rozenberg Sandrine, Besse Sophie, Amour Julien, Vivien Benoît, Tavernier Benoît, Riou Bruno
Laboratory of Anesthesiology, Université Pierre et Marie Curie, Paris, France.
Anesthesiology. 2006 Nov;105(5):961-7. doi: 10.1097/00000542-200611000-00017.
The myocardial negative inotropic effects of desflurane are less pronounced than those of other halogenated anesthetics, partly because of intramyocardial catecholamine store release. However, the effects of desflurane on aging myocardium are unknown, whereas aging is known to be associated with an attenuation of catecholamine responsiveness.
The effects of desflurane (1.9-9.3 vol%) were studied in left ventricular papillary muscle of adult and senescent rats (29 degrees C; 0.5 mm Ca; stimulation frequency 12 pulses/min). The inotropic effects were compared under low and high loads, using the maximum unloaded shortening velocity and maximum isometric active force, and without or with alpha- and beta-adrenoceptor blockade.
Desflurane induced a moderate positive inotropic effect in adult rats but a negative inotropic effect in senescent rats. After alpha- and beta-adrenoceptor blockade, desflurane induced a comparable negative inotropic effect in adult and senescent rats. No lusitropic effect under low load was observed, whereas desflurane induced a slight but significant positive lusitropic effect under high load similar between the two groups of rats. This positive effect was abolished by adrenoceptor blockade.
The authors' study suggests that desflurane does not induce significant intramyocardial catecholamine release in senescent myocardium, a result that should be integrated in the well-known alteration in the catecholamine response during aging.
地氟烷对心肌的负性肌力作用不如其他卤代麻醉剂明显,部分原因是心肌内儿茶酚胺储存的释放。然而,地氟烷对衰老心肌的影响尚不清楚,而衰老已知与儿茶酚胺反应性减弱有关。
研究地氟烷(1.9 - 9.3体积%)对成年和老年大鼠左心室乳头肌的影响(29℃;0.5 mmol/L钙离子;刺激频率12次/分钟)。使用最大无负荷缩短速度和最大等长主动力,在低负荷和高负荷条件下,以及在无或有α和β肾上腺素能受体阻断的情况下比较肌力作用。
地氟烷在成年大鼠中诱导中度正性肌力作用,但在老年大鼠中诱导负性肌力作用。在α和β肾上腺素能受体阻断后,地氟烷在成年和老年大鼠中诱导相当的负性肌力作用。在低负荷下未观察到变时性作用,而地氟烷在高负荷下诱导轻微但显著的正性变时性作用,两组大鼠相似。该正性作用被肾上腺素能受体阻断消除。
作者的研究表明,地氟烷在衰老心肌中不会诱导显著的心肌内儿茶酚胺释放,这一结果应结合到衰老过程中儿茶酚胺反应的已知变化中。