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当心尖部血流严重受限且存在芬太尼时,维拉帕米对犬左心室功能的影响。

Effect of verapamil on canine left ventricular function in the presence of fentanyl when apical blood flow is critically limited.

作者信息

Diedericks J, Leone B J, Philbin D M, Foëx P

机构信息

Nuffield Department of Anaesthetics, Radcliffe Infirmary, Oxford.

出版信息

Br J Anaesth. 1989 Oct;63(4):458-64. doi: 10.1093/bja/63.4.458.

Abstract

Instruments were inserted to seven dogs under halothane anaesthesia, to measure global and regional left ventricular function. Anaesthesia was continued with fentanyl (100 micrograms kg-1 bolus, then 1.5 micrograms kg-1 min-1). Critical constriction was applied to the left anterior descending coronary artery. Control recordings were made, followed by bolus administration of verapamil 0.08, 0.16 and 0.32 mg kg-1, with recordings 10 min after each bolus. At the highest dose, verapamil decreased systemic arterial pressure, left ventricular dP/dt, stroke volume and systemic vascular resistance, and increased heart rate significantly. Coronary perfusion pressure decreased and, in the presence of critical constriction, coronary flow per beat decreased significantly. In the region with constriction, systolic shortening of myocardium decreased and post-systolic shortening increased significantly with addition of verapamil. The addition of a high dose of verapamil to fentanyl anaesthesia caused reduction in systolic function and development of early diastolic dysfunction in myocardium with critically limited blood supply.

摘要

在氟烷麻醉下将仪器插入七只狗体内,以测量左心室整体和局部功能。麻醉持续使用芬太尼(100微克/千克静脉推注,然后1.5微克/千克/分钟)。对左前降支冠状动脉进行临界性缩窄。进行对照记录,随后静脉推注维拉帕米0.08、0.16和0.32毫克/千克,并在每次推注后10分钟进行记录。在最高剂量时,维拉帕米降低了体动脉压、左心室dP/dt、每搏输出量和体循环血管阻力,并显著增加了心率。冠状动脉灌注压降低,在临界性缩窄情况下,每搏冠状动脉血流量显著减少。在缩窄区域,加入维拉帕米后心肌收缩期缩短减少,收缩后期缩短显著增加。在芬太尼麻醉中加入高剂量维拉帕米会导致血液供应严重受限的心肌收缩功能降低和早期舒张功能障碍的发生。

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