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右美托咪定输注期间兔呼气末二氧化碳分压变化对口腔组织血流的影响。

Effect of changes in end-tidal carbon dioxide tension on oral tissue blood flow during dexmedetomidine infusion in rabbits.

作者信息

Okada Reina, Matsuura Nobuyuki, Kasahara Masataka, Ichinohe Tatsuya

机构信息

Department of Dental Anesthesiology, Tokyo Dental College, Chiba, Japan.

出版信息

Eur J Oral Sci. 2015 Feb;123(1):24-9. doi: 10.1111/eos.12162. Epub 2014 Dec 29.

Abstract

A decrease in arterial carbon dioxide tension induces an increase in masseter muscle blood flow and a decrease in mandibular bone marrow blood flow during general anesthesia. In addition, dexmedetomidine infusion reduces oral tissue blood flow. In this study we investigated how end-tidal carbon dioxide tension (ET-CO2 ) changes influence on oral tissue blood flow during continuous dexmedetomidine infusion in rabbits. Eleven male Japan White rabbits were anesthetized with sevoflurane. Then, ET-CO2 was set at 30 mmHg and adjusted to 40 and 60 mmHg, and heart rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure, common carotid artery blood flow, mandibular bone marrow blood flow, masseter muscle blood flow, and blood flow in other oral tissues were measured. Following this, the ET-CO2 was returned to 30 mmHg and dexmedetomidine was infused over 60 min. The measurements were repeated. Most parameters increased, regardless of whether or not dexmedetomidine was present, and heart rate and masseter muscle blood flow decreased in an ET-CO2 -dependent manner. Dexmedetomidine infusion suppressed ET-CO2 -dependent masseter muscle blood flow change. Masseter muscle blood flow during ET-CO2 at 30 mmHg with dexmedetomidine was the same as that during ET-CO2 at 40 mmHg without dexmedetomidine. Our findings suggest that dexmedetomidine infusion and slight hypocapnia under general anesthesia suppress an increase in masseter muscle blood flow as well as reducing mandibular bone marrow blood flow. These results may be of significance for decreasing bleeding during oral and maxillofacial surgery.

摘要

全身麻醉期间,动脉血二氧化碳分压降低会导致咬肌血流量增加,下颌骨骨髓血流量减少。此外,输注右美托咪定可减少口腔组织血流量。在本研究中,我们调查了在兔持续输注右美托咪定期间,呼气末二氧化碳分压(ET-CO2)变化如何影响口腔组织血流量。11只雄性日本白兔用七氟醚麻醉。然后,将ET-CO2设定为30 mmHg,并分别调整至40 mmHg和60 mmHg,测量心率、收缩压、舒张压、平均动脉压、颈总动脉血流量、下颌骨骨髓血流量、咬肌血流量以及其他口腔组织的血流量。之后,将ET-CO2恢复至30 mmHg,并在60分钟内输注右美托咪定。重复进行测量。无论是否使用右美托咪定,大多数参数都会增加,且心率和咬肌血流量以ET-CO2依赖的方式降低。输注右美托咪定可抑制ET-CO2依赖的咬肌血流量变化。在30 mmHg的ET-CO2下使用右美托咪定期间的咬肌血流量与在40 mmHg的ET-CO2下未使用右美托咪定期间的咬肌血流量相同。我们的研究结果表明,全身麻醉期间输注右美托咪定和轻度低碳酸血症可抑制咬肌血流量增加,并减少下颌骨骨髓血流量。这些结果可能对减少口腔颌面外科手术中的出血具有重要意义。

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