Vettermann J, Beck K C, Lindahl S G, Brichant J F, Rehder K
Department of Anesthesiology, Mayo Clinic, Rochester, Minnesota 55905.
Anesthesiology. 1988 Nov;69(5):688-95. doi: 10.1097/00000542-198811000-00009.
The effects of enflurane, isoflurane, vecuronium, atracurium, and pancuronium on pulmonary resistance and heart rate were studied in 30 vagotomized dogs lying supine and anesthetized with chloralose-urethane. None of the five drugs affected pulmonary resistance when the airway was unstimulated. Enflurane and isoflurane significantly attenuated the increase in pulmonary resistance induced by electrical stimulation of the vagus nerves. This effect was dose-dependent and similar for both anesthetics at equivalent multiples of their minimum alveolar concentration. Atracurium significantly (P less than 0.05) enhanced the increase in pulmonary resistance induced by vagus nerve stimulation; vecuronium had no significant effect. Pancuronium, up to a cumulative dose of 0.14 mg/kg, also significantly (P less than 0.05) enhanced the increase in pulmonary resistance induced by vagus nerve stimulation; but this effect was reversed by further increasing the dose. Pancuronium also attenuated the cardiodecelerator response to vagus nerve stimulation in a dose-dependent fashion. The underlying mechanisms for the attenuation of responses to vagus nerve stimulation by enflurane or isoflurane or for the increase in response with atracurium are unknown. Pancuronium at lower doses increases the response most likely by blocking prejunctional muscarinic receptors (M2) that physiologically inhibit vagally mediated increases in pulmonary resistance.
在30只仰卧且用氯醛糖-乌拉坦麻醉的迷走神经切断犬中，研究了恩氟烷、异氟烷、维库溴铵、阿曲库铵和泮库溴铵对肺阻力和心率的影响。当气道未受刺激时，这五种药物均未影响肺阻力。恩氟烷和异氟烷能显著减弱迷走神经电刺激所致的肺阻力增加。这种效应呈剂量依赖性，且两种麻醉药在其最低肺泡浓度的等效倍数时作用相似。阿曲库铵显著（P<0.05）增强了迷走神经刺激所致的肺阻力增加；维库溴铵无显著作用。泮库溴铵在累积剂量达0.14mg/kg时，也显著（P<0.05）增强了迷走神经刺激所致的肺阻力增加；但进一步增加剂量可逆转此效应。泮库溴铵还以剂量依赖性方式减弱了对迷走神经刺激的心脏减速反应。恩氟烷或异氟烷减弱对迷走神经刺激反应或阿曲库铵增强反应的潜在机制尚不清楚。较低剂量的泮库溴铵最有可能通过阻断生理性抑制迷走神经介导的肺阻力增加的节前毒蕈碱受体（M2）来增强反应。
