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硝苯地平经口长期预处理后氟烷或异氟烷的血液动力学和心脏动力学作用。一项动物实验研究

[Hemo- and cardiodynamic action of halothane or isoflurane following peroral long-term pretreatment with nifedipine. An animal experimental study].

作者信息

Theissen J L, Vigfusson G, Brüssel T, Dreyer P, Loick M, van Aken H, Lunkenheimer P P

机构信息

Klinik und Poliklinik für Anaesthesiologie und Operative Intensivmedizin, Westfälische Wilhelms-Universität Münster.

出版信息

Anaesthesist. 1990 Mar;39(3):179-85.

PMID:2331055
Abstract

This study investigated the influence of chronic oral nifedipine on the hemodynamic effects of halothane or isoflurane anesthesia in dogs. Under general anesthesia with fentanyl 0.3 microgram/kg/min i.v. and 3:1 N2O/O2 inhalation mixture a left thoracotomy was performed and two needle force probes were placed in the left ventricular wall to measure myocardial force of contraction. In the halothane group (n = 12) a Hall-effect sensor was placed on the anterior surface of the left ventricle, which in combination with a magnet on the posterior surface allowed measurements of left ventricular diameter. In the isoflurane group (n = 15) a Widney gauge was placed around the left ventricle to measure left ventricular circumference changes. The dogs were also monitored with left ventricular tip manometers, pulmonary arterial thermodilution catheters, and femoral arterial and venous catheters. Prior to surgery, in the halothane group 6 dogs were pretreated with nifedipine 6 mg/kg p.o. for 10 days; the other 6 served as controls. In the isoflurane group, 8 dogs were pretreated with nifedipine in the same way and 7 served as controls. Three hours after instrumentation baseline hemodynamic measurements were performed and repeated 15 min after adding 1 MAC and then 2 MAC halothane or isoflurane. Oral pretreatment with nifedipine caused vasodilation with a significant decrease in systemic vascular resistance (SVR) and mean arterial pressure (MAP); heart rate (HR) and dp/dt max were unchanged in comparison to the control group. The cardiac output (CO) increased. Halothane (1 MAC/2 MAC) had a dose-related circulatory depressant effect. This occurred to the same extent in both groups.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

本研究调查了慢性口服硝苯地平对犬氟烷或异氟烷麻醉时血流动力学效应的影响。在静脉注射0.3微克/千克/分钟芬太尼和吸入3:1氧化亚氮/氧气混合气体的全身麻醉下,进行左胸廓切开术,并在左心室壁放置两个针式测力探头以测量心肌收缩力。在氟烷组(n = 12)中,在左心室前表面放置一个霍尔效应传感器,其与后表面的磁体相结合可测量左心室直径。在异氟烷组(n = 15)中,在左心室周围放置一个维德尼测量仪以测量左心室周长变化。还用左心室尖部压力计、肺动脉热稀释导管以及股动脉和静脉导管对犬进行监测。手术前,氟烷组6只犬口服6毫克/千克硝苯地平预处理10天;另外6只作为对照。在异氟烷组中,8只犬以同样方式用硝苯地平预处理,7只作为对照。仪器安装后3小时进行基线血流动力学测量,并在添加1 MAC和2 MAC氟烷或异氟烷后15分钟重复测量。硝苯地平口服预处理导致血管舒张,全身血管阻力(SVR)和平均动脉压(MAP)显著降低;与对照组相比,心率(HR)和dp/dt max未改变。心输出量(CO)增加。氟烷(1 MAC/2 MAC)具有剂量相关的循环抑制作用。两组中这种作用程度相同。(摘要截短为250字)

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