Department of Anesthesiology and Intensive Care Medicine, University Hospital Hradec Kralove, Charles University in Prague, Faculty of Medicine in Hradec Kralove, Hradec Kralove, Czech Republic.
Clin Hemorheol Microcirc. 2012;51(3):213-23. doi: 10.3233/CH-2011-1527.
This study aimed to investigate the effects of intravenous anesthetics on hepatosplanchnic microcirculation in laparotomized mechanically ventilated rats using Sidestream Dark-field (SDF) imaging. Thirty male Wistar rats were divided into 5 groups (n = 6 each). All rats were initially anesthetized with 60 mg/kg pentobarbital (i.p.) for instrumentation. This was followed by either ketamine, propofol, thiopental, midazolam or saline+fentanyl (iv bolus over 5 min and then maintenance over 90 min). SDF imaging of the liver and distal ileum microcirculation was performed at the baseline and at t = 5, 35, 65 and 95 min. In propofol group there was increase of functional sinusoidal density (FSD) following induction (+25%, P < 0.05) and maintenance at t = 95 min (+10.3%, P < 0.05), in ketamine and midazolam group decrease of FSD was observed after induction (-20.4%, P < 0.05; -10.1%, P < 0.05) and during maintenance at t = 65 min (-11.6%, P < 0.05; -11.4%, P < 0.05) when compared to baseline. Following induction with propofol functional capillary density (FCD) of ileal longitudinal muscle layer increased (+10.6%, P < 0.05) and returned to baseline values during maintenance. Ketamine and midazolam decreased FCD of longitudinal layer after induction (-24.6%, P < 0.05; -21.1%, P < 0.05) and remained decreased during maintenance at t = 95 min (-10.8%, P < 0.05; -15.5%, P < 0.05). In thiopental and control group, changes in microcirculatory parameters were not significant throughout the study. In conclusion, intravenous anesthetics affect the hepatosplanchnic microcirculation differentially, propofol has shown protective effect on the liver and intestinal microcirculation.
本研究旨在使用边流暗场（SDF）成像技术研究静脉麻醉剂对剖腹机械通气大鼠肝脾微循环的影响。30 只雄性 Wistar 大鼠分为 5 组（每组 6 只）。所有大鼠最初均用 60mg/kg 戊巴比妥（ip）麻醉进行仪器操作。随后给予氯胺酮、异丙酚、硫喷妥钠、咪达唑仑或生理盐水+芬太尼（iv 推注 5 分钟，然后维持 90 分钟）。在基线和 t = 5、35、65 和 95 分钟时对肝脏和远端回肠微循环进行 SDF 成像。在异丙酚组中，诱导后（+25%，P<0.05）和维持时（t=95 分钟时，+10.3%，P<0.05）功能窦状密度（FSD）增加，在氯胺酮和咪达唑仑组中，诱导后（-20.4%，P<0.05；-10.1%，P<0.05）和维持时（t=65 分钟时，-11.6%，P<0.05；-11.4%，P<0.05）FSD 下降与基线相比。诱导后，回肠纵行肌层的功能毛细血管密度（FCD）增加（+10.6%，P<0.05），并在维持时恢复到基线值。氯胺酮和咪达唑仑诱导后降低了纵行层的 FCD（-24.6%，P<0.05；-21.1%，P<0.05），并在维持时 t=95 分钟时仍保持较低水平（-10.8%，P<0.05；-15.5%，P<0.05）。在硫喷妥钠和对照组中，整个研究过程中微循环参数的变化均不显著。结论：静脉麻醉剂对肝脾微循环的影响不同，异丙酚对肝脏和肠道微循环有保护作用。
