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异氟烷麻醉对马脑血管自动调节功能的影响。

Effects of isoflurane anesthesia on cerebrovascular autoregulation in horses.

作者信息

Brosnan Robert J, Steffey Eugene P, LeCouteur Richard A, Esteller-Vico Alejandro, Vaughan Betsy, Liu Irwin K M

机构信息

Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, CA 95616, USA.

出版信息

Am J Vet Res. 2011 Jan;72(1):18-24. doi: 10.2460/ajvr.72.1.18.

Abstract

OBJECTIVE

To test a hypothesis predicting that isoflurane would interfere with cerebrovascular autoregulation in horses and to evaluate whether increased mean arterial blood pressure (MAP) would increase cerebral blood flow and intracranial pressure (ICP) during isoflurane anesthesia.

ANIMALS

6 healthy adult horses.

PROCEDURES

Horses were anesthetized with isoflurane at a constant end-tidal concentration sufficient to maintain MAP at 60 mm Hg. The facial, carotid, and dorsal metatarsal arteries were catheterized for blood sample collection and pressure measurements. A sub-arachnoid transducer was used to measure ICP Fluorescent microspheres were injected through a left ventricular catheter during MAP conditions of 60 mm Hg, and blood samples were collected. This process was repeated with different-colored microspheres at the same isoflurane concentration during MAP conditions of 80 and 100 mm Hg achieved with IV administration of dobutamine. Central nervous system tissue samples were obtained after euthanasia to quantify fluorescence and calculate blood flow.

RESULTS

Increased MAP did not increase ICP or blood flow in any of the brain tissues examined. However, values for blood flow were low for all tested brain regions except the pons and cerebellum. Spinal cord blood flow was significantly decreased at the highest MAP.

CONCLUSIONS AND CLINICAL RELEVANCE

Results suggested that healthy horses autoregulate blood flow in the CNS at moderate to deep planes of isoflurane anesthesia. Nonetheless, relatively low blood flows in the brain and spinal cord of anesthetized horses may increase risks for hypoperfusion and neurologic injury.

摘要

目的

检验一个假设,即异氟烷会干扰马的脑血管自动调节功能,并评估在异氟烷麻醉期间平均动脉血压(MAP)升高是否会增加脑血流量和颅内压(ICP)。

动物

6匹健康成年马。

步骤

用异氟烷对马进行麻醉,维持恒定的呼气末浓度,使MAP维持在60 mmHg。将面部、颈动脉和背侧跖动脉插管,用于采集血样和测量血压。使用蛛网膜下腔换能器测量ICP。在MAP为60 mmHg的条件下,通过左心室导管注入荧光微球,并采集血样。在静脉注射多巴酚丁胺使MAP达到80和100 mmHg的相同异氟烷浓度下,用不同颜色的微球重复该过程。安乐死后获取中枢神经系统组织样本,以量化荧光并计算血流量。

结果

在所有检测的脑组织中,MAP升高均未增加ICP或血流量。然而,除脑桥和小脑外,所有测试脑区的血流量值均较低。在最高MAP时,脊髓血流量显著降低。

结论及临床意义

结果表明,在异氟烷麻醉的中至深平面,健康马可自动调节中枢神经系统的血流量。尽管如此,麻醉马的脑和脊髓血流量相对较低,可能会增加灌注不足和神经损伤风险。

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