Gursoy Sinan, Bagcivan Ihsan, Durmus Nedim, Kaygusuz Kenan, Kol Iclal Ozdemir, Yildirim Sahin, Mimaroglu Caner
Department of Anaesthesiology, Cumhuriyet University School of Medicine, Sivas, Turkey.
Eur J Anaesthesiol. 2009 Feb;26(2):155-9. doi: 10.1097/EJA.0b013e32831a461f.
Pancuronium, vecuronium, mivacurium and rocuronium are nondepolarizing neuromuscular blocking agents, which are competitive antagonists against acetylcholine at nicotinic receptors, and considered to have no direct actions on vascular smooth muscle. We aimed to investigate the relaxant effects and possible underlying mechanisms of these agents on isolated rat thoracic aorta.
The preparations were precontracted with prostaglandin F2alpha (10(-7) mol l(-1)) and pancuronium (10(-7)-10(-4) mol l(-1)), rocuronium (10(-7)-10(-4) mol l(-1)), vecuronium (10(-7)-10(-4) mol l(-1)) and mivacurium (10(-7)-10(-4) mol l(-1)) added at cumulative concentrations in the presence or absence of a prostaglandin synthesis inhibitor, indomethacin (10(-6) M), and a nitric oxide synthesis inhibitor, N(omega)-nitro-L-arginine methylester (3 x 10(-5)). The same protocol was applied to both endothelia (+) and endothelia (-) aortic rings. The preparations precontracted with prostaglandin F2alpha (10(-7) mol l(-1)) were stimulated with electrical field stimulation at a frequency of 10 Hz as square-wave pulses of 50 V (0.2 ms) in the presence of a noradrenaline reuptake inhibitor desipramine (10(-7) mol l(-1)) and a nonselective beta-blocker propranolol (10(-6) mol l(-1)). Drugs were added at ineffective concentration of 10(-7) mol l(-1). Tetrodotoxin (10(-7) mol l(-1)) was added to test whether the changes were dependent on the neuronal response.
Pancuronium and rocuronium relaxed aortic rings precontracted by prostaglandin F2alpha in a dose-dependent manner, but vecuronium and mivacurium did not. The relaxation effect of pancuronium and rocuronium was endothelium independent because there was not a significant response difference from the endothelium-denuded group.
In conclusion, their relaxation effect may be due to an increase in prostaglandin synthesis. The increased relaxation effect of these agents at electrical field stimulation may be by the decreasing effect of noradrenaline reuptake from nerve endings because a noradrenaline reuptake inhibitor desipramine did not change this effect. Also, these neuromuscular agents may affect beta-receptors, because a nonselective beta-blocker agent, propranolol, decreased their electrical field stimulation-induced relaxations.
泮库溴铵、维库溴铵、米库氯铵和罗库溴铵均为非去极化型神经肌肉阻滞剂,它们是烟碱样受体处乙酰胆碱的竞争性拮抗剂,且被认为对血管平滑肌无直接作用。我们旨在研究这些药物对离体大鼠胸主动脉的舒张作用及其可能的潜在机制。
制备物先用前列腺素F2α(10⁻⁷mol/L)预收缩,然后在存在或不存在前列腺素合成抑制剂吲哚美辛(10⁻⁶M)和一氧化氮合成抑制剂N(ω)-硝基-L-精氨酸甲酯(3×10⁻⁵)的情况下,以累积浓度加入泮库溴铵(10⁻⁷ - 10⁻⁴mol/L)、罗库溴铵(10⁻⁷ - 10⁻⁴mol/L)、维库溴铵(10⁻⁷ - 10⁻⁴mol/L)和米库氯铵(10⁻⁷ - 10⁻⁴mol/L)。相同方案应用于内皮完整(+)和内皮剥脱(-)的主动脉环。先用前列腺素F2α(10⁻⁷mol/L)预收缩的制备物,在存在去甲肾上腺素再摄取抑制剂地昔帕明(10⁻⁷mol/L)和非选择性β受体阻滞剂普萘洛尔(10⁻⁶mol/L)的情况下,以50V(0.2ms)的方波脉冲、10Hz的频率进行电场刺激。以无效浓度10⁻⁷mol/L加入药物。加入河豚毒素(10⁻⁷mol/L)以测试这些变化是否依赖于神经元反应。
泮库溴铵和罗库溴铵能使由前列腺素F2α预收缩的主动脉环呈剂量依赖性舒张,但维库溴铵和米库氯铵则不能。泮库溴铵和罗库溴铵的舒张作用不依赖于内皮,因为与内皮剥脱组相比,其反应无显著差异。
总之,它们的舒张作用可能是由于前列腺素合成增加。这些药物在电场刺激时增强的舒张作用可能是由于神经末梢去甲肾上腺素再摄取减少,因为去甲肾上腺素再摄取抑制剂地昔帕明并未改变这种作用。此外,这些神经肌肉药物可能会影响β受体,因为非选择性β受体阻滞剂普萘洛尔会减弱它们在电场刺激诱导下的舒张作用。