Adachi Hitoshi
Department of Anesthesiology, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, 113, Tokyo, Japan.
J Anesth. 1996 Jun;10(2):129-132. doi: 10.1007/BF02483349.
This study evaluated the effects of inhalational anesthetics on hemodynamic changes in response to head-up tilt in humans. Twenty-four patients were randomly divided into three groups that received either halothane, isoflurane, or sevoflurane. Changes in heart rate, blood pressure, and plasma norepinephrine concentrations were determined before and during head-up tilt position in the awake and anesthetized state. Head-up tilt caused a significant increase in the heart rate, concomitantly with a decrease or no significant changes in systolic blood pressure in the awake state. However, under 2 minimum alveolar concentrations (MAC) of halothane and isoflurane anesthesia, the heart rate did not significantly change during head-up tilt in spite of significant decreases in systolic blood pressure. In contrast, under 2 MAC of sevoflurane anesthesia, the heart rate significantly increased during head-up tilt. Plasma norepinephrine did not significantly alter during head-up tilt in the awake as well as the anesthetized state. These results suggest that sevoflurane maintains an increase in heart rate in response to head-up tilt, whereas halothane and isoflurane attenuate the response.
本研究评估了吸入性麻醉剂对人体头高位倾斜时血流动力学变化的影响。24例患者被随机分为三组，分别接受氟烷、异氟烷或七氟烷麻醉。在清醒和麻醉状态下，于头高位倾斜前及倾斜过程中测定心率、血压和血浆去甲肾上腺素浓度的变化。头高位倾斜在清醒状态下可导致心率显著增加，同时收缩压降低或无显著变化。然而，在氟烷和异氟烷麻醉2倍最低肺泡浓度（MAC）时，尽管收缩压显著降低，但头高位倾斜过程中心率无显著变化。相比之下，在七氟烷麻醉2倍MAC时，头高位倾斜过程中心率显著增加。在清醒及麻醉状态下头高位倾斜过程中，血浆去甲肾上腺素均无显著变化。这些结果表明，七氟烷可维持头高位倾斜时心率增加，而氟烷和异氟烷则减弱这种反应。
