Frink E J, Morgan S E, Coetzee A, Conzen P F, Brown B R
Department of Anesthesiology, University of Arizona Health Sciences Center, Tucson 85724.
Anesthesiology. 1992 Jan;76(1):85-90. doi: 10.1097/00000542-199201000-00013.
Inhalational anesthetics produce differential effects on hepatic blood flow and oxygenation that may impact hepatocellular function and drug clearance. In this investigation, the effects of sevoflurane on hepatic blood flow and oxygenation were compared with those of enflurane, halothane, and isoflurane in ten chronically instrumented greyhound dogs. Each dog randomly received enflurane, halothane, isoflurane, and sevoflurane, each at 1.0, 1.5, and 2.0 MAC concentrations. Mean arterial blood pressure and cardiac output decreased in a dose-dependent fashion during all four anesthetics studied. Heart rate increased compared to control during enflurane, isoflurane, and sevoflurane anesthesia and did not change during halothane anesthesia. Hepatic arterial blood flow and portal venous blood flow were measured by chronically implanted electromagnetic flow probes. Hepatic O2 delivery and consumption were calculated after hepatic arterial, portal venous, and hepatic venous blood gas analysis. Hepatic arterial blood flow was maintained with sevoflurane and isoflurane. Halothane and enflurane reduced hepatic arterial blood flow during all anesthetic levels compared to control (P less than 0.05), with marked reductions occurring with 1.5 and 2.0 MAC halothane concomitant with an increase in hepatic arterial vascular resistance. Portal venous blood flow was reduced with isoflurane and sevoflurane at 1.5 and 2.0 MAC. A somewhat greater reduction in portal venous blood flow occurred during 2.0 MAC sevoflurane (P less than 0.05 compared to control and 1.0 MAC values for sevoflurane). Enflurane reduced portal venous blood flow at 1.0, 1.5, and 2.0 MAC compared to control. Halothane produced the greatest reduction in portal venous blood flow (P less than 0.05 compared to sevoflurane).(ABSTRACT TRUNCATED AT 250 WORDS)
吸入性麻醉剂对肝血流和氧合产生不同影响,这可能会影响肝细胞功能和药物清除。在本研究中,在十只长期植入仪器的灵缇犬中,比较了七氟醚与安氟醚、氟烷和异氟醚对肝血流和氧合的影响。每只犬随机接受安氟醚、氟烷、异氟醚和七氟醚,每种药物浓度分别为1.0、1.5和2.0 MAC。在研究的所有四种麻醉剂作用期间,平均动脉血压和心输出量呈剂量依赖性下降。与对照组相比,在安氟醚、异氟醚和七氟醚麻醉期间心率增加,而在氟烷麻醉期间心率未改变。通过长期植入的电磁流量探头测量肝动脉血流和门静脉血流。在进行肝动脉、门静脉和肝静脉血气分析后,计算肝氧输送和氧消耗。七氟醚和异氟醚可维持肝动脉血流。与对照组相比,在所有麻醉水平下,氟烷和安氟醚均降低肝动脉血流(P<0.05),在1.5和2.0 MAC氟烷时出现显著降低,同时肝动脉血管阻力增加。异氟醚和七氟醚在1.5和2.0 MAC时可降低门静脉血流。在2.0 MAC七氟醚期间,门静脉血流减少幅度更大(与对照组和七氟醚1.0 MAC值相比,P<0.05)。与对照组相比,安氟醚在1.0、1.5和2.0 MAC时可降低门静脉血流。氟烷使门静脉血流减少最多(与七氟醚相比,P<0.05)。(摘要截断于250字)