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β-肾上腺素能阻滞剂作用下肺对乙酰甲胆碱的反应性:普萘洛尔与艾司洛尔的比较

Pulmonary reactivity to methacholine during beta-adrenergic blockade: propranolol versus esmolol.

作者信息

Tobias J D, Sauder R A, Hirshman C A

机构信息

Department of Anesthesiology/Critical Care Medicine, Johns Hopkins University, Baltimore, Maryland.

出版信息

Anesthesiology. 1990 Jul;73(1):132-6. doi: 10.1097/00000542-199007000-00019.

Abstract

Pulmonary reactivity to methacholine after equipotent beta-blocking doses of propranolol and esmolol was compared in seven basenji-greyhound dogs during thiopental-fentanyl anesthesia. Equipotent doses of esmolol and propranolol were determined by both heart rate effects and by isoproterenol response curves. Propranolol (2 mg/kg) was administered intravenously as a bolus dose and esmolol (0.4-0.5 mg.kg-1.min-1) was administered by continuous infusion. Both esmolol and propranolol significantly decreased heart rate and mean arterial pressure (P less than 0.001). Baseline pulmonary resistance and dynamic compliance did not change after the administration of either propranolol or esmolol. However, propranolol significantly shifted the methacholine dose-response curve to the left so that methacholine (0.3 mg/ml) increased pulmonary resistance by 7.9 +/- 0.97 cmH2O.l-1.s-1 (mean +/- SEM of seven dogs) after pretreatment with propranolol but only 4.4 +/- 0.89 cmH2O.l-1.s-1 (P less than 0.05) without propranolol pretreatment (control). Esmolol, however, did not significantly shift the methacholine dose-response curve. Methacholine (0.3 mg/ml) increased resistance 4.0 +/- 0.89 cmH2O.l-1.s-1 during esmolol administration. This study shows that at equipotent beta 1-blocking doses, propranolol, but not esmolol, produces significant increases in pulmonary reactivity to methacholine.

摘要

在硫喷妥钠-芬太尼麻醉期间,对7只巴仙吉犬-灵缇犬进行了比较,观察在等效β受体阻滞剂剂量的普萘洛尔和艾司洛尔作用下,肺对乙酰甲胆碱的反应性。通过心率效应和异丙肾上腺素反应曲线确定艾司洛尔和普萘洛尔的等效剂量。普萘洛尔(2mg/kg)静脉推注给药,艾司洛尔(0.4-0.5mg·kg-1·min-1)持续输注给药。艾司洛尔和普萘洛尔均显著降低心率和平均动脉压(P<0.001)。给予普萘洛尔或艾司洛尔后,基线肺阻力和动态顺应性均未改变。然而,普萘洛尔使乙酰甲胆碱剂量反应曲线显著左移,因此在普萘洛尔预处理后,乙酰甲胆碱(0.3mg/ml)使肺阻力增加7.9±0.97cmH2O·l-1·s-1(7只犬的平均值±标准误),而未用普萘洛尔预处理(对照)时仅增加4.4±0.89cmH2O·l-1·s-1(P<0.05)。然而,艾司洛尔并未使乙酰甲胆碱剂量反应曲线显著移位。在输注艾司洛尔期间,乙酰甲胆碱(0.3mg/ml)使阻力增加4.0±0.89cmH2O·l-1·s-1。本研究表明,在等效β1受体阻滞剂量下,普萘洛尔而非艾司洛尔会使肺对乙酰甲胆碱的反应性显著增加。

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