Bayındır Selen, Gökmen Necati, Erbayraktar Serhat, Küçükgüçlü Semih, Yılmaz Osman, Şahin Ömer, Öçmen Elvan, Erdost Hale Aksu, Sağıroğlu Emel
Department of Anaesthesiology, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey.
Department of Neurosurgery, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey.
Turk J Anaesthesiol Reanim. 2015 Aug;43(4):225-31. doi: 10.5152/TJAR.2015.88319. Epub 2015 Mar 3.
In this study, the antiarrhythmic and anti-ischemic effects of a 6 μg kg(-1) min(-1) infusion dose of remifentanil are investigated in a central sympathetic hyperactivity model in rabbits.
In this study, 18 New Zealand rabbits were used. The subjects were randomly divided into three groups (n=6) and received 10 μmol L(-1) glutamate intracerebroventricularly to provide the central sympathetic hyperactivity. In group 1, 10 μmol L(-1) glutamate was used; in group 2, 1 h before L-glutamate injection, 40 mg kg(-1) N (omega)-nitro-L-arginine methyl ester was intravenously (iv) administered; and in group 3, also 1 h before L-glutamate injection, 40 mg kg(-1) N (omega)-nitro-L-arginine methyl ester was iv administered. A 6 μg kg(-1) min(-1) dose of remifentanil infusion was administered 5 min before L-glutamate injection. Heart rate, systolic arterial pressure and mean arterial pressure were measured and recorded. Within 15 min of the intracerebroventricular L-glutamate injection, premature ventricular complexes, bigeminy ventricular arrhythmia, ventricular tachycardia, ST-segment shift and T-wave inversions were recorded.
When incidences of heart rate, rate pressure product, premature ventricular complexes and bigeminy ventricular arrhythmia were compared between groups, significant differences were not determined. Mean arterial pressure was more significantly increased in group 2 than in the other groups (p<0.05). Ventricular tachycardia, ST-segment shift and T-wave inversions were significantly lower in group 3 than in groups 1 and 2 (p<0.05).
Remifentanil (6 μg kg(-1) min(-1) for 5 min of infusion) prevented life-threatening ventricular tachycardia and electrocardiographic signs of myocardial ischemia in a model of arrhythmia resulting from the association of central sympathetic overactivity.
在本研究中,在兔中枢交感神经过度活跃模型中研究6μg·kg⁻¹·min⁻¹输注剂量的瑞芬太尼的抗心律失常和抗缺血作用。
本研究使用18只新西兰兔。将实验对象随机分为三组(n = 6),并经脑室注射10μmol·L⁻¹谷氨酸以诱导中枢交感神经过度活跃。第1组使用10μmol·L⁻¹谷氨酸;第2组在注射L-谷氨酸前1小时静脉注射40mg·kg⁻¹N(ω)-硝基-L-精氨酸甲酯;第3组同样在注射L-谷氨酸前1小时静脉注射40mg·kg⁻¹N(ω)-硝基-L-精氨酸甲酯。在注射L-谷氨酸前5分钟给予6μg·kg⁻¹·min⁻¹剂量的瑞芬太尼输注。测量并记录心率、收缩压和平均动脉压。在脑室内注射L-谷氨酸的15分钟内,记录室性早搏、室性二联律、室性心动过速、ST段移位和T波倒置。
比较各组间心率、心率血压乘积、室性早搏和室性二联律的发生率时,未发现显著差异。第2组的平均动脉压比其他组显著升高(p < 0.05)。第3组的室性心动过速、ST段移位和T波倒置显著低于第1组和第2组(p < 0.05)。
在中枢交感神经过度活跃所致心律失常模型中,瑞芬太尼(6μg·kg⁻¹·min⁻¹输注5分钟)可预防危及生命的室性心动过速和心肌缺血的心电图表现。