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α2肾上腺素能激动剂美托咪定的立体异构体在氟烷麻醉犬体内的麻醉和血流动力学效应

Anesthetic and hemodynamic effects of the stereoisomers of medetomidine, an alpha 2-adrenergic agonist, in halothane-anesthetized dogs.

作者信息

Vickery R G, Sheridan B C, Segal I S, Maze M

机构信息

Anesthesiology Service, Veterans Administration Medical Center, Palo Alto, CA 94304.

出版信息

Anesth Analg. 1988 Jul;67(7):611-5.

PMID:2898219
Abstract

The anesthetic-sparing and hemodynamic effects of the stereoisomers of the highly selective alpha 2-adrenergic agonist medetomidine were studied in halothane-anesthetized dogs. Male beagles were anesthetized with halothane in oxygen. After a 2-hour equilibration period, halothane MAC and baseline hemodynamic functions were determined. DL-(n = 7), D- (n = 5), or L-medetomidine (n = 5) at 1, 3, and 10 micrograms/kg was administered via a right atrial port over 15 minutes while each dog was given halothane at the MAC dose for that animal. Twenty minutes after the end of infusion (when the hemodynamic variables were stable), hemodynamic function was reassessed. Halothane MAC was then redetermined. MAC for halothane significantly decreased after DL-medetomidine administration in a dose-dependent fashion to the extent that at the highest dose (10 micrograms/kg) the halothane MAC was less than 0.1%. This effect could be mimicked by the D-isomer, whereas the L-isomer was without effect. Neither isomer changed the mean arterial pressure, whereas only the D-isomer significantly decreased heart rate and cardiac output. Medetomidine, the highly selective alpha 2-adrenergic agonist, reduces the MAC for volatile anesthesia by a greater degree than with any other physiologic, pharmacologic, or pathologic intervention thus far reported. The fact that this effect is stereospecific suggests a structure activity relation that can be accounted for by a homogeneous receptor population. The role of medetomidine as a supplemental anesthetic agent appears promising and requires further investigation.

摘要

在氟烷麻醉的犬中研究了高选择性α2-肾上腺素能激动剂美托咪定立体异构体的麻醉节省效应和血流动力学效应。雄性比格犬用氟烷和氧气进行麻醉。在2小时的平衡期后,测定氟烷最低肺泡有效浓度(MAC)和基线血流动力学功能。在每只犬以其MAC剂量给予氟烷的同时,经右心房端口在15分钟内给予1、3和10微克/千克的消旋美托咪定(n = 7)、右旋美托咪定(n = 5)或左旋美托咪定(n = 5)。输注结束后20分钟(当血流动力学变量稳定时),重新评估血流动力学功能。然后重新测定氟烷MAC。给予消旋美托咪定后,氟烷MAC以剂量依赖性方式显著降低,在最高剂量(10微克/千克)时,氟烷MAC小于0.1%。这种效应可被右旋异构体模拟,而左旋异构体无此作用。两种异构体均未改变平均动脉压,而只有右旋异构体显著降低心率和心输出量。高选择性α2-肾上腺素能激动剂美托咪定比迄今为止报道的任何其他生理、药理或病理干预措施更能降低挥发性麻醉的MAC。这种效应具有立体特异性这一事实表明存在一种可由同质受体群体解释的构效关系。美托咪定作为辅助麻醉剂的作用似乎很有前景,需要进一步研究。

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