Department of Cardiology, Shanghai First People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200080, China.
Acta Pharmacol Sin. 2011 Jun;32(6):817-23. doi: 10.1038/aps.2011.42.
The hypnotic agent propofol is effective for the induction and maintenance of anesthesia. However, recent studies have shown that propofol administration is related to arrhythmias. Propofol displays both pro- and anti-arrhythmic effects in a concentration-dependent manner. Data indicate that propofol can convert supraventricular tachycardia and ventricular tachycardia and may inhibit the conduction system of the heart. The mechanism of the cardiac effects remains poorly defined and may involve ion channels, the autonomic nervous system and cardiac gap junctions. Specifically, sodium, calcium and potassium currents in cardiac cells are suppressed by clinically relevant concentrations of propofol. Propofol shortens the action potential duration (APD) but lessens the ischemia-induced decrease in the APD. Furthermore, propofol suppresses both sympathetic and parasympathetic tone and preserves gap junctions during ischemia. All of these effects cumulatively contribute to the antiarrhythmic and proarrhythmic properties of propofol.
催眠剂异丙酚可有效诱导和维持麻醉。然而，最近的研究表明，异丙酚的使用与心律失常有关。异丙酚以浓度依赖性方式表现出促心律失常和抗心律失常作用。有数据表明，异丙酚可转变室上性心动过速和室性心动过速，并可能抑制心脏的传导系统。心脏效应的机制仍未明确，可能涉及离子通道、自主神经系统和心脏缝隙连接。具体来说，心脏细胞中的钠、钙和钾电流被临床相关浓度的异丙酚抑制。异丙酚缩短动作电位时程（APD），但减轻了 APD 在缺血时的减少。此外，异丙酚在缺血期间抑制交感神经和副交感神经，并保留缝隙连接。所有这些作用共同导致异丙酚的抗心律失常和致心律失常特性。
