Scheller M S, Nakakimura K, Fleischer J E, Zornow M H
Department of Anaesthesiology, University of California, San Diego, La Jolla 92093.
Br J Anaesth. 1990 Sep;65(3):388-92. doi: 10.1093/bja/65.3.388.
The cerebral effects of sevoflurane were compared in dogs with those of enflurane and isoflurane. Initially, the minimum alveolar concentrations (MAC) of sevoflurane and enflurane were determined and the electroencephalographic (EEG) responses to increasing doses of sevoflurane (1.5, 2.0 and 2.5 MAC) or enflurane (1.5 and 2.0 MAC) in unparalysed animals were examined. Administration of sevoflurane was not associated with seizure activity at any concentration either during normocapnia (PaCO2 5.3 kPa) or hypocapnia (PaCO2 2.7 kPa), even in the presence of intense auditory stimuli. All dogs anaesthetized with enflurane demonstrated sustained EEG and motor evidence of seizure activity induced by auditory stimuli at concentrations of enflurane greater than 1 MAC, particularly during hypocapnia. In a separate group of dogs, the effects of increasing concentrations of sevoflurane and isoflurane (0.5, 1.5 and 2.15 MAC) were compared directly on arterial pressure, cardiac output and heart rate, cerebral blood flow and the cerebral metabolic rate for oxygen (CMRO2) using the venous outflow technique. Sevoflurane, in common with isoflurane, had minimal effects on cerebral blood flow at the concentrations studied, but significantly reduced the CMRO2 at end-tidal concentrations sufficient to produce a burst suppression pattern on the EEG (approximately 2.15 MAC). Both sevoflurane and isoflurane significantly decreased arterial pressure in a dose-dependent manner, but neither drug significantly altered cardiac output.
在犬类中比较了七氟烷与恩氟烷和异氟烷对大脑的影响。首先,测定了七氟烷和恩氟烷的最低肺泡有效浓度(MAC),并检查了未麻痹动物对递增剂量的七氟烷(1.5、2.0和2.5 MAC)或恩氟烷(1.5和2.0 MAC)的脑电图(EEG)反应。在正常碳酸血症(动脉血二氧化碳分压[PaCO2] 5.3 kPa)或低碳酸血症(PaCO2 2.7 kPa)期间,无论七氟烷处于何种浓度,即使存在强烈的听觉刺激,给药后均未出现癫痫活动。所有用恩氟烷麻醉的犬在恩氟烷浓度大于1 MAC时,尤其是在低碳酸血症期间,均表现出由听觉刺激诱发的持续EEG和运动性癫痫活动证据。在另一组犬中,使用静脉流出技术直接比较了递增浓度的七氟烷和异氟烷(0.5、1.5和2.15 MAC)对动脉压、心输出量和心率、脑血流量以及脑氧代谢率(CMRO2)的影响。与异氟烷一样,在所研究的浓度下,七氟烷对脑血流量的影响最小,但在呼气末浓度足以在EEG上产生爆发抑制模式(约2.15 MAC)时,可显著降低CMRO2。七氟烷和异氟烷均以剂量依赖性方式显著降低动脉压,但两种药物均未显著改变心输出量。