Kwon N J, Stolte A L, Farina J P
Department of Anesthesiology, George Washington University Medical Center, Washington, DC.
J Cardiothorac Anesth. 1989 Oct;3(5):532-5. doi: 10.1016/0888-6296(89)90148-8.
The arrhythmogenic threshold was investigated during acute and chronic hypokalemia under halothane anesthesia with an epinephrine challenge in the rat model. It was hypothesized that in the setting of severe hypokalemia, general anesthesia would be arrhythmogenic and would be exaggerated with increased levels of catecholamines. Rats were divided into four groups as follows: normokalemic control (group I, n = 10), acute hypokalemia with furosemide (group II, n = 16), acute hypokalemia with hyperventilation (group III, n = 18), and chronic hypokalemia induced by a low potassium (K+) diet (group IV, n = 22). There were no significant differences (P less than .05) in baseline K+ and arterial blood gases among the four groups. There was a significant difference between groups I and II and groups I and IV (P less than 0.05) in serum K+ values after the low K+ diet, but no differences were observed between groups II and IV or groups I and III in serum K+ levels. There was no significant difference in myocardial tissue K+ among the four groups. There was a significant difference in the arrhythmic dose of epinephrine among the four groups (P less than 0.05). Acute hypokalemia was more prone to dysrhythmias than chronic hypokalemia. However, compared with control, acute and chronic hypokalemia groups were resistant to dysrhythmias is probably based on compensatory mechanisms. The heart seems more resistant to K+ changes than skeletal muscle. This resistance is associated with compensation by the cardiac muscle sodium pump in the face of K+ depletion. Hypokalemia per se did not increase the incidence of dysrhythmias under halothane anesthesia in rats.
在大鼠模型中,于氟烷麻醉下通过肾上腺素激发试验研究急性和慢性低钾血症期间的致心律失常阈值。研究假设,在严重低钾血症情况下,全身麻醉会引发心律失常,且随着儿茶酚胺水平升高会加剧。大鼠分为以下四组:正常血钾对照组(I组,n = 10)、用速尿导致急性低钾血症组(II组,n = 16)、通过过度通气导致急性低钾血症组(III组,n = 18)以及通过低钾(K+)饮食诱导慢性低钾血症组(IV组,n = 22)。四组之间的基线K+和动脉血气无显著差异(P < 0.05)。低钾饮食后,I组与II组以及I组与IV组的血清K+值存在显著差异(P < 0.05),但II组与IV组或I组与III组之间的血清K+水平无差异。四组心肌组织K+无显著差异。四组之间肾上腺素的致心律失常剂量存在显著差异(P < 0.05)。急性低钾血症比慢性低钾血症更易发生心律失常。然而,与对照组相比,急性和慢性低钾血症组对心律失常有抵抗力,这可能基于代偿机制。心脏似乎比骨骼肌对K+变化更具抵抗力。这种抵抗力与面对K+耗竭时心肌钠泵的代偿有关。低钾血症本身并未增加大鼠在氟烷麻醉下心律失常的发生率。