Belo S E, Mazer C D
Department of Anaesthesia, University of Toronto, St. Michael's Hospital, Ontario, Canada.
Anesthesiology. 1990 Dec;73(6):1243-51. doi: 10.1097/00000542-199012000-00024.
Short periods of coronary artery occlusion are known to produce prolonged periods of ventricular dysfunction. The effects of halothane or isoflurane on contractility and metabolism in postischemic "stunned" myocardium were studied in an open-chest canine model in which the left anterior descending artery (LAD) was occluded for 15 min and then reperfused. Regional function in the LAD and circumflex artery (CIRC) areas were measured with sonomicrometry, and metabolic data were determined from simultaneous arterial and venous measurements of oxygen and lactate. Halothane and isoflurane produced equivalent decreases in systolic shortening in both normal (CIRC) and stunned (LAD) areas of the heart. Furthermore, the amount of depression was similar with either halothane or isoflurane. Halothane 0.75 MAC significantly decreased systolic shortening in both the LAD region (from 38.8 +/- 25.9% to 11.0 +/- 21.8%) and in the CIRC region (from 116.7 +/- 24.7% to 87.5 +/- 23.3%). At equivalent MAC concentrations of isoflurane, the values were 42.5 +/- 45.7 to -7.0 +/- 49.9% in the LAD region and 91.5 +/- 11.9% to 66.9 +/- 23.9% in the CIRC area. At 1.5-MAC halothane, systolic shortening in the LAD region decreased from 47.9 +/- 47.2% to -0.6 +/- 20.3% and in the CIRC area from 114.6 +/- 16.8% to 76.0 +/- 18.7%. Isoflurane at 1.5 MAC produced significant decreases, from 23.4 +/- 54.5% to -15.6 +/- 27.1% in the LAD region and from 94.4 +/- 33.2% to 61.3 +/- 28.2 in the CIRC area.(ABSTRACT TRUNCATED AT 250 WORDS)
已知短时间的冠状动脉闭塞会导致长时间的心室功能障碍。在开胸犬模型中研究了氟烷或异氟烷对缺血后“顿抑”心肌收缩力和代谢的影响,该模型中左前降支动脉(LAD)闭塞15分钟后再灌注。用超声测量法测量LAD和回旋支动脉(CIRC)区域的局部功能,并通过同时测量动脉和静脉的氧和乳酸来确定代谢数据。氟烷和异氟烷在心脏的正常(CIRC)和顿抑(LAD)区域均使收缩期缩短程度同等降低。此外,氟烷或异氟烷导致的降低程度相似。0.75MAC的氟烷使LAD区域的收缩期缩短显著降低(从38.8±25.9%降至11.0±21.8%),CIRC区域也降低(从116.7±24.7%降至87.5±23.3%)。在等效MAC浓度的异氟烷作用下,LAD区域的值为42.5±45.7至-7.0±49.9%,CIRC区域为91.5±11.9%至66.9±23.9%。1.5-MAC的氟烷使LAD区域的收缩期缩短从47.9±47.2%降至-0.6±20.3%,CIRC区域从114.6±16.8%降至76.0±18.7%。1.5MAC的异氟烷使LAD区域显著降低,从23.4±54.5%降至-15.6±27.1%,CIRC区域从94.4±33.2%降至61.3±28.2。(摘要截取自250字)