Bein Berthold, Christ Torsten, Eberhart Leopold H J
Department of Anesthesiology and Intensive Care Medicine, Asklepios Hospital St. Georg Hamburg, Germany.
Department of Experimental Pharmacology and Toxicology, University Medical Centre Hamburg-EppendorfHamburg, Germany; Germany and German Centre for Cardiovascular Research, University Medical Centre Hamburg-EppendorfHamburg, Germany.
Front Pharmacol. 2017 Feb 21;8:68. doi: 10.3389/fphar.2017.00068. eCollection 2017.
A 20:1 combination of cafedrine:theodrenaline (Akrinor®) is widely used in Germany for the treatment of hypotensive states during anesthesia and in emergency medicine. Although this drug formulation has been available since 1963, there are few studies relating to its use and many of the data are only available in German. In this article, we summarize the available data and propose mechanisms for the effects of cafedrine/theodrenaline on cardiac muscle cells and vascular smooth muscle cells. Cafedrine/theodrenaline leads to a rapid increase in mean arterial pressure that is characterized by increased cardiac preload, stroke volume, and cardiac output. Systemic vascular resistance and heart rate remain mostly unchanged. Factors which impact the effects of cafedrine/theodrenaline are gender, high arterial pressure at baseline, use of β-blockers, and heart failure. Importantly, the drug is frequently used in obstetric anesthesia without detrimental effects on umbilical cord pH or APGAR score.
咖啡因与茶碱按20:1比例混合的制剂（Akrinor®）在德国被广泛用于治疗麻醉期间的低血压状态以及急救医学领域。尽管这种药物制剂自1963年就已问世，但关于其应用的研究较少，且许多数据仅以德语提供。在本文中，我们总结了现有数据，并提出了咖啡因/茶碱对心肌细胞和血管平滑肌细胞作用的机制。咖啡因/茶碱可使平均动脉压迅速升高，其特征是心脏前负荷、每搏输出量和心输出量增加。全身血管阻力和心率大多保持不变。影响咖啡因/茶碱作用的因素包括性别、基线时的高血压、β受体阻滞剂的使用以及心力衰竭。重要的是，该药物常用于产科麻醉，对脐带血pH值或阿氏评分没有不良影响。
