Boldt J, Dieterich H A, Kling D, Hempelmann G
Department of Anesthesiology and Intensive Care Medicine, Justus-Liebig-University Giessen, F.R.G.
J Cardiovasc Pharmacol. 1989;14 Suppl 1:S50-6.
Enoximone belongs to a new class of inotropic drugs that are not related either to digitalis or to catecholamines. It acts primarily through selective inhibition of phosphodiesterase III (PDE-III) and has additional vasodilating properties. Hemodynamic effects of intravenously administered enoximone (0.5 mg/kg) were investigated in patients undergoing aortocoronary bypass grafting before and during anesthesia as well as during extracorporeal circulation (ECC). Patients who were impossible to be weaned off ECC without pharmacological support were investigated also. A significant increase in cardiac index and dp/dtmax, a decrease in pulmonary capillary pressure, and a small decrease in mean arterial pressure were the major hemodynamic effects. Heart rate was not changed and no signs of arrhythmia were seen during the entire investigation period. Interactions with the anesthetics used could not be observed in this study. In patients with impaired myocardial performance during weaning from ECC, enoximone seems to be helpful in stabilizing cardiac output and decreasing filling pressure. The mechanism for improvement appears to be enhanced contractility due to its positive inotropic effects, as well as a decrease in left ventricular outflow resistance resulting from peripheral vasodilation.
依诺昔酮属于一类新型的强心药物，它既与洋地黄无关，也与儿茶酚胺无关。它主要通过选择性抑制磷酸二酯酶III（PDE-III）发挥作用，并具有额外的血管舒张特性。对接受主动脉冠状动脉搭桥术的患者在麻醉前、麻醉期间以及体外循环（ECC）期间静脉注射依诺昔酮（0.5mg/kg）后的血流动力学效应进行了研究。对于那些没有药物支持就无法脱离ECC的患者也进行了研究。主要的血流动力学效应包括心脏指数和dp/dtmax显著增加、肺毛细血管压力降低以及平均动脉压略有下降。在整个研究期间，心率没有变化，也未观察到心律失常的迹象。在本研究中未观察到与所用麻醉剂的相互作用。对于在脱离ECC过程中心肌功能受损的患者，依诺昔酮似乎有助于稳定心输出量并降低充盈压。改善的机制似乎是由于其正性肌力作用增强了收缩力，以及外周血管舒张导致左心室流出阻力降低。
