Kemmochi Masahiro, Ichinohe Tatsuya, Kaneko Yuzuru
Department of Dental Anesthesiology, Tokyo Dental College, Chiba, Japan.
J Oral Maxillofac Surg. 2009 Jun;67(6):1245-50. doi: 10.1016/j.joms.2008.06.008.
The purpose of this study was to investigate the effect of remifentanil on the blood flow in rabbit oral tissues during propofol or sevoflurane anesthesia.
Thirty-two male tracheotomized Japanese white rabbits were anesthetized with propofol (P group) or sevoflurane (S group) under mechanical ventilation. Animals were further divided into 4 groups: adenosine triphosphate (ATP) treatment in the P group (P-ATP) (n = 8), remifentanil treatment in the P group (P-Remi) (n = 8), ATP treatment in the S group (S-ATP) (n = 8), and remifentanil treatment in the S group (S-Remi) (n = 8). Blood pressure, heart rate, common carotid artery blood flow (CABF), lingual mucosal blood flow (LMBF), and mandibular bone marrow blood flow (BMBF) were measured during each period before and during infusion of ATP or remifentanil.
Mean arterial pressure (MAP), CABF, LMBF, and BMBF showed a significant decrease in all 4 groups during infusion of the drug. Similarly, LMBF and BMBF showed significant decreases in both the ATP and remifentanil groups, whereas the decreases in MAP and CABF measured as percent change were greater in the ATP groups than in the remifentanil groups. A significant correlation was observed between CABF and BMBF in the S-Remi group. In both the P and S groups, the correlations between MAP and LMBF or BMBF were relatively strong when ATP was administered.
Our findings suggest that infusion of remifentanil during propofol or sevoflurane anesthesia reduces BMBF and LMBF, as does deliberate hypotension by use of ATP, without a major decrease in MAP.
本研究旨在探讨瑞芬太尼对兔在丙泊酚或七氟醚麻醉期间口腔组织血流的影响。
32只雄性气管切开的日本白兔在机械通气下分别用丙泊酚(P组)或七氟醚(S组)麻醉。动物进一步分为4组:P组三磷酸腺苷(ATP)处理组(P-ATP)(n = 8)、P组瑞芬太尼处理组(P-Remi)(n = 8)、S组ATP处理组(S-ATP)(n = 8)和S组瑞芬太尼处理组(S-Remi)(n = 8)。在输注ATP或瑞芬太尼之前及期间的每个时间段测量血压、心率、颈总动脉血流量(CABF)、舌黏膜血流量(LMBF)和下颌骨骨髓血流量(BMBF)。
在输注药物期间,所有4组的平均动脉压(MAP)、CABF、LMBF和BMBF均显著下降。同样,LMBF和BMBF在ATP组和瑞芬太尼组均显著下降,而以百分比变化衡量的MAP和CABF下降在ATP组比在瑞芬太尼组更大。在S-Remi组中观察到CABF与BMBF之间存在显著相关性。在P组和S组中,当给予ATP时,MAP与LMBF或BMBF之间的相关性相对较强。
我们的研究结果表明,在丙泊酚或七氟醚麻醉期间输注瑞芬太尼可降低BMBF和LMBF,使用ATP进行控制性低血压时也是如此,且MAP无显著下降。