Bernard J M, Doursout M F, Wouters P, Hartley C J, Cohen M, Merin R G, Chelly J E
Department of Anesthesiology, Baylor College of Medicine, Houston, Texas.
Anesthesiology. 1991 Feb;74(2):298-302. doi: 10.1097/00000542-199102000-00016.
Seven dogs were chronically instrumented for measurements of mean aortic blood pressure and cardiac output and for simultaneous measurements of hepatic, portal, and renal blood flows. Each animal was studied on two separate occasions, awake and during 1.2, 1.4, 1.75, and 2.0 MAC isoflurane and enflurane. Both anesthetics induced tachycardia; to a greater degree than isoflurane, enflurane lowered mean aortic blood pressure in a dose-dependent manner (-37, -45, -48, and -62% vs. -19, -25, -41, and -44%, respectively) and cardiac output (-20, -26, -41, and -48% vs. -3, -5, -11, and -15%, respectively). With isoflurane, cardiac output decreased only at 1.75 and 2.0 MAC, and portal blood flow did not change significantly, whereas hepatic arterial blood flow increased at 1.75 and 2 MAC (by 28 and 33%, respectively). With enflurane, no significant changes were recorded in hepatic arterial blood flow, whereas portal blood flow decreased in a dose-dependent manner. Except at 2 MAC, hepatic circulation did not differ between anesthetics. Likewise, neither anesthetic significantly changed renal blood flow, except for enflurane at 2.0 MAC, which was associated with a 35% reduction. Both anesthetics led to similar systemic, hepatic, and renal vasodilations. Our data suggest that high concentrations of enflurane are associated with decreases in portal, total hepatic, and renal blood flows, most likely as a result of an anesthetic-induced cardiac depression.
七只狗被长期植入仪器,用于测量平均主动脉血压和心输出量,并同时测量肝、门静脉和肾血流量。每只动物在两个不同的状态下接受研究,即清醒状态以及处于1.2、1.4、1.75和2.0倍最低肺泡有效浓度(MAC)的异氟烷和恩氟烷麻醉状态下。两种麻醉剂均诱发心动过速;与异氟烷相比,恩氟烷更能以剂量依赖的方式降低平均主动脉血压(分别为-37%、-45%、-48%和-62%,而异氟烷分别为-19%、-25%、-41%和-44%)和心输出量(分别为-20%、-26%、-41%和-48%,而异氟烷分别为-3%、-5%、-11%和-15%)。使用异氟烷时,心输出量仅在1.75和2.0 MAC时降低,门静脉血流量无显著变化,而肝动脉血流量在1.75和2 MAC时增加(分别增加28%和33%)。使用恩氟烷时,肝动脉血流量无显著变化,而门静脉血流量以剂量依赖的方式减少。除了在2 MAC时,两种麻醉剂对肝循环的影响没有差异。同样,两种麻醉剂均未显著改变肾血流量,但2.0 MAC的恩氟烷除外,它会使肾血流量减少35%。两种麻醉剂均导致相似的全身、肝脏和肾脏血管舒张。我们的数据表明,高浓度的恩氟烷与门静脉、总肝血流量和肾血流量的减少有关,这很可能是麻醉引起的心脏抑制的结果。