Physiology Department, University of Puerto Rico-School of Medicine, San Juan, PR.
Diab Vasc Dis Res. 2011 Oct;8(4):299-302. doi: 10.1177/1479164111421035.
People with diabetes are at increased risk of cardiovascular (CV) morbidity and mortality during surgery. The most appropriate anaesthetic induction agent for these patients is unknown.
We assessed the CV effects of propofol, etomidate and ketamine in streptozotocin (65 mg/kg, IP) diabetic rats. In non-diabetic rats, none of these anaesthetics significantly modified cardiac output, heart rate or stroke volume, but ketamine increased systolic blood pressure (SBP) compared to etomidate and propofol (89.6 ± 2.4 mmHg, vs. 72.7 ± 3.0 and 75.4 ± 1.9; p < 0.05). In diabetic rats, by contrast, cardiac output was lower with ketamine (82.6 ± 14 ml/min) and etomidate (78.2 ± 15.8 ml/min) than with propofol (146 ± 21 ml/min, N = 8, p < 0.01). SBP, however, was higher in the propofol-treated group (93.3 ± 3.4 mmHg, p < 0.05).
These results suggest that hyperglycaemia modifies CV responses to induction anaesthetics.
糖尿病患者在手术期间患心血管（CV）发病率和死亡率的风险增加。这些患者最合适的麻醉诱导剂尚不清楚。
我们评估了异丙酚、依托咪酯和氯胺酮对链脲佐菌素（65mg/kg，IP）诱导的糖尿病大鼠的 CV 效应。在非糖尿病大鼠中，这些麻醉剂均未显著改变心输出量、心率或每搏量，但与依托咪酯和异丙酚相比，氯胺酮增加了收缩压（SBP）（89.6±2.4mmHg，vs.72.7±3.0 和 75.4±1.9；p<0.05）。相比之下，在糖尿病大鼠中，氯胺酮（82.6±14ml/min）和依托咪酯（78.2±15.8ml/min）的心脏输出量低于异丙酚（146±21ml/min，N=8，p<0.01）。然而，在接受异丙酚治疗的组中，SBP 较高（93.3±3.4mmHg，p<0.05）。
这些结果表明高血糖症改变了诱导麻醉剂对 CV 反应。
