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舒芬太尼-右美托咪定麻醉与芬太尼/氟烷-咪达唑仑麻醉相比,可减少实验性心肌梗死大鼠的室性心律失常和死亡率,并限制再灌注后的梗死面积。

Sufentanil-medetomidine anaesthesia compared with fentanyl/fluanisone-midazolam is associated with fewer ventricular arrhythmias and death during experimental myocardial infarction in rats and limits infarct size following reperfusion.

机构信息

1 Department of Cardiology, Academic Medical Centre, Amsterdam, The Netherlands.

2 Netherlands Heart Institute, Utrecht, The Netherlands.

出版信息

Lab Anim. 2018 Jun;52(3):271-279. doi: 10.1177/0023677217724485. Epub 2017 Aug 4.

Abstract

To improve infarct healing following myocardial infarction in humans, therapeutic interventions can be applied during the inflammatory response. Animal models are widely used to study this process. However, induction of MI in rodents is associated with high mortality due to ventricular fibrillation (VF) during coronary artery ligation. The anaesthetic agent used during the procedure appears to influence the frequency of this complication. In this retrospective study, the effect on ventricular arrhythmia incidence during ligation and infarct size following in vivo reperfusion of two anaesthetic regimens, sufentanil-medetomidine (SM) and fentanyl/fluanisone-midazolam (FFM) was evaluated in rats. Anaesthetics were administered subcutaneously using fentanyl/fluanisone (0.5 mL/kg) with midazolam (5 mg/kg) (FFM group, n = 48) or sufentanil (0.05 mg/kg) with medetomidine (0.15 mg/kg) (SM group, n = 47). The coronary artery was ligated for 40 min to induce MI. Heart rate and ventricular arrhythmias were recorded during ligation, and infarct size was measured via histochemistry after three days of reperfusion. In the SM group, heart rate and VF incidence were lower throughout the experiment compared with the FFM group (6% versus 30%) ( P < 0.01). Fatal VF did not occur in the SM group whereas this occurred in 25% of the animals in the FFM group. Additionally, after three days of reperfusion, the infarcted area following SM anaesthesia was less than half as large as that following FFM anaesthesia (8.5 ± 6.4% versus 20.7 ± 5.6%) ( P < 0.01). Therefore, to minimize the possibility of complications related to VF and acute death arising during ligation, SM anaesthesia is recommended for experimental MI in rats.

摘要

为了改善人类心肌梗死后的梗死愈合,可在炎症反应期间进行治疗干预。动物模型被广泛用于研究这个过程。然而,由于冠状动脉结扎期间的心室颤动(VF),啮齿动物的 MI 诱导与高死亡率相关。在手术过程中使用的麻醉剂似乎会影响这种并发症的频率。在这项回顾性研究中,评估了两种麻醉方案(舒芬太尼-右美托咪定(SM)和芬太尼/氟烷-咪达唑仑(FFM))在皮下给药后,对结扎期间室性心律失常发生率和体内再灌注后梗死面积的影响。使用芬太尼/氟烷(0.5mL/kg)和咪达唑仑(5mg/kg)(FFM 组,n=48)或舒芬太尼(0.05mg/kg)和右美托咪定(0.15mg/kg)(SM 组,n=47)给予麻醉剂。结扎冠状动脉 40min 以诱导 MI。在结扎过程中记录心率和室性心律失常,并在再灌注 3 天后通过组织化学测量梗死面积。在 SM 组中,整个实验过程中心率和 VF 发生率均低于 FFM 组(6%比 30%)(P<0.01)。SM 组未发生致命性 VF,但 FFM 组有 25%的动物发生 VF。此外,再灌注 3 天后,SM 麻醉后的梗死面积小于 FFM 麻醉后的梗死面积的一半(8.5±6.4%比 20.7±5.6%)(P<0.01)。因此,为了最大程度地减少与 VF 相关的并发症的可能性,并避免结扎期间出现急性死亡,建议在大鼠实验性 MI 中使用 SM 麻醉。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cef8/5967036/384e7243514e/10.1177_0023677217724485-fig1.jpg

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