Nishizawa Shuya, Ichinohe Tatsuya, Kaneko Yuzuru
Department of Dental Anesthesiology, Tokyo Dental College, Tokyo, Japan.
J Oral Maxillofac Surg. 2012 Apr;70(4):797-802. doi: 10.1016/j.joms.2011.10.012. Epub 2012 Feb 9.
The purpose of this study was to investigate the effects of naloxone and phentolamine on the blood flow changes in rabbit oral tissue induced by remifentanil during sevoflurane anesthesia.
Male Japan White rabbits were anesthetized with sevoflurane under mechanical ventilation. Remifentanil was continuously infused at a rate of 0.4 μg/kg/min. Naloxone 0.01 mg/kg or phentolamine 0.01 mg/kg was administered during remifentanil infusion. Observed variables were systolic and diastolic blood pressures, mean arterial pressure, heart rate, common carotid artery blood flow, tongue mucosal blood flow, mandibular bone marrow blood flow, masseter muscle blood flow, and upper and lower alveolar tissue blood flows. The common carotid artery blood flow was monitored continuously using an ultrasonic blood flowmeter. Tongue mucosal blood flow was monitored continuously using a laser Doppler blood flowmeter. Mandibular bone marrow blood flow, masseter muscle blood flow, and upper and lower alveolar tissue blood flows were measured using a hydrogen clearance tissue blood flowmeter. One-way analysis of variance for repeated measurements followed by the Student-Newman-Keuls test was used.
Remifentanil produced decreases in the heart rate, systolic blood pressure, and common carotid artery blood flow by about 15% and mandibular bone marrow blood flow, masseter muscle blood flow, and upper and lower alveolar tissue blood flows by about 30%. In the naloxone group, all variables recovered after naloxone administration. In contrast, in the phentolamine group, tissue blood flow recovered, whereas heart rate, systolic blood pressure, and common carotid artery blood flow did not recover after phentolamine administration.
Remifentanil deceased oral tissue blood flow and systemic hemodynamic variables. Naloxone and phentolamine produced a recovery of oral tissue blood flow with and without systemic hemodynamic recovery, respectively.
本研究旨在探讨纳洛酮和酚妥拉明对瑞芬太尼在七氟醚麻醉期间诱导的兔口腔组织血流变化的影响。
雄性日本白兔在机械通气下用七氟醚麻醉。以0.4μg/kg/min的速率持续输注瑞芬太尼。在输注瑞芬太尼期间给予0.01mg/kg的纳洛酮或0.01mg/kg的酚妥拉明。观察变量包括收缩压和舒张压、平均动脉压、心率、颈总动脉血流、舌黏膜血流、下颌骨髓血流、咬肌血流以及上下牙槽组织血流。使用超声血流仪连续监测颈总动脉血流。使用激光多普勒血流仪连续监测舌黏膜血流。使用氢清除组织血流仪测量下颌骨髓血流、咬肌血流以及上下牙槽组织血流。采用重复测量的单因素方差分析，随后进行Student-Newman-Keuls检验。
瑞芬太尼使心率、收缩压和颈总动脉血流降低约15%，使下颌骨髓血流、咬肌血流以及上下牙槽组织血流降低约30%。在纳洛酮组，给予纳洛酮后所有变量均恢复。相比之下，在酚妥拉明组，组织血流恢复，而给予酚妥拉明后心率、收缩压和颈总动脉血流未恢复。
瑞芬太尼降低口腔组织血流和全身血流动力学变量。纳洛酮和酚妥拉明分别在有和无全身血流动力学恢复的情况下使口腔组织血流恢复。
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