Gragasin Ferrante S, Davidge Sandra T
Department of Anesthesiology and Pain Medicine, University of Alberta, Edmonton, Canada.
Am J Physiol Heart Circ Physiol. 2009 Jul;297(1):H466-74. doi: 10.1152/ajpheart.01317.2008. Epub 2009 May 22.
Hypotension following administration of propofol, an anesthetic agent, is strongly predicted by advanced age and is partly due to direct vasodilation. We hypothesized that propofol increases nitric oxide (NO)-mediated vasodilation by enhancing its bioavailability in the aged adult vasculature, leading to greater vasodilation than in the young adult. Small mesenteric arteries from rats aged 13-15 versus 3 to 4 mo were compared in this study. Reactivity to propofol (1-100 microM) alone and with the addition of acetylcholine (ACh; 0.1-10 microM) in endothelial-intact and dunuded arteries following phenylephrine constriction was assessed using myography. N(G)-nitro-L-arginine methyl ester (L-NAME) and meclofenamate (Meclo) were used to inhibit NO and prostaglandin synthesis, respectively. Superoxide dismutase (SOD) and catalase were used as antioxidants during ACh relaxation and were compared with propofol in aging arteries. Propofol alone induced greater relaxation in 1) endothelial-intact compared with denuded arteries and 2) aged compared with young arteries, which were inhibited by L-NAME. ACh-induced relaxation was greater in young compared with aged control arteries; however, propofol pretreatment increased this relaxation in aged but not in young arteries. Additionally, propofol inhibited ACh-induced relaxation in arteries treated with L-NAME + Meclo [relaxation attributed to endothelium-derived hyperpolarizing factor (EDHF)]. Pretreatment with SOD and catalase increased relaxation to ACh in aged arteries similar to propofol. In conclusion, propofol causes relaxation in small mesenteric arteries in an endothelial-dependent and independent manner and increases ACh-induced relaxation in aged arteries. Interestingly, propofol inhibits EDHF-mediated relaxation but increases availability of NO, which leads to overall vascular relaxation.
麻醉剂丙泊酚给药后出现的低血压在高龄患者中表现明显,部分原因是直接血管舒张作用。我们推测,丙泊酚通过提高老年成人血管系统中一氧化氮(NO)的生物利用度,增强了NO介导的血管舒张作用,从而导致比年轻成人更大程度的血管舒张。本研究比较了13 - 15月龄大鼠与3 - 4月龄大鼠的小肠系膜小动脉。使用肌动描记法评估在苯肾上腺素收缩后,完整内皮和去内皮动脉中单独使用丙泊酚(1 - 100 microM)以及添加乙酰胆碱(ACh;0.1 - 10 microM)时的反应性。分别使用N(G)-硝基-L-精氨酸甲酯(L-NAME)和甲氯芬那酸(Meclo)抑制NO和前列腺素的合成。在ACh舒张过程中,使用超氧化物歧化酶(SOD)和过氧化氢酶作为抗氧化剂,并与老年动脉中的丙泊酚进行比较。单独使用丙泊酚时,1)完整内皮动脉比去内皮动脉舒张作用更强,2)老年动脉比年轻动脉舒张作用更强,且这些舒张作用均被L-NAME抑制。与老年对照动脉相比,ACh诱导的年轻动脉舒张作用更强;然而,丙泊酚预处理增加了老年动脉的这种舒张作用,而年轻动脉中未增加。此外,丙泊酚抑制了用L-NAME + Meclo处理的动脉中ACh诱导的舒张作用[归因于内皮衍生超极化因子(EDHF)的舒张作用]。用SOD和过氧化氢酶预处理可增加老年动脉对ACh的舒张作用,类似于丙泊酚。总之,丙泊酚以内皮依赖性和非依赖性方式使小肠系膜小动脉舒张,并增加老年动脉中ACh诱导的舒张作用。有趣的是,丙泊酚抑制EDHF介导的舒张作用,但增加了NO的可用性,从而导致整体血管舒张。