Lanier W L, Milde J H, Michenfelder J D
Anesthesiology. 1985 Dec;63(6):589-97. doi: 10.1097/00000542-198512000-00007.
Pancuronium decreases the minimal alveolar anesthetic concentration (MAC) of halothane in humans, while atracurium has a metabolite, laudanosine, which is a known cerebral stimulant. To determine if these muscle relaxants significantly alter cerebral function, their effects on cerebral metabolic rate (CMRo2), cerebral blood flow (CBF), intracranial pressure (ICP), EEG, and the cerebral energy state were studied in halothane-anesthetized dogs. Group A dogs (n = 6) were maintained at 0.86% end-expired (1.0 MAC) halothane. Thereafter, a sequence of 1) pancuronium 0.1 mg . kg-1; 2) reversal of neuromuscular blockade with neostigmine plus glycopyrrolate; and 3) pancuronium 0.2 mg . kg-1 produced no changes in CMRo2, CBF, ICP, or EEG. Group B dogs (n = 6) also were maintained at 0.86% end-expired halothane and received the following in sequence: 1) atracurium 0.5 mg . kg-1; 2) reversal of neuromuscular blockade with neostigmine plus glycopyrrolate; 3) atracurium 1.0 mg . kg-1; and 4) atracurium 2.5 mg . kg-1. There were no changes in CMRo2, CBF, or ICP; EEG evidence of cerebral arousal occurred in only one dog with the final dose of atracurium. Group C dogs (n = 6) received tetracaine spinal anesthesia and the minimal halothane concentration (mean +/- SE = 0.69 +/- 0.03% end-expired) that would maintain an "anesthetic" EEG pattern. Each Group C dog received the following in sequence: 1) atracurium 1.0 mg . kg-1, and 2) atracurium 2.5 mg . kg-1. EEG evidence of cerebral arousal occurred in all six Group C dogs. Arousal was not accompanied by significant increases in CBF, CMRo2, or ICP.(ABSTRACT TRUNCATED AT 250 WORDS)
潘库溴铵可降低人体中氟烷的最低肺泡麻醉浓度(MAC),而阿曲库铵有一种代谢产物劳丹诺辛,它是一种已知的脑兴奋剂。为了确定这些肌肉松弛剂是否会显著改变脑功能,研究了它们在氟烷麻醉犬身上对脑代谢率(CMRo2)、脑血流量(CBF)、颅内压(ICP)、脑电图(EEG)和脑能量状态的影响。A组犬(n = 6)维持在0.86%的呼气末氟烷浓度(1.0 MAC)。此后,依次给予1)0.1 mg·kg-1的潘库溴铵;2)用新斯的明加格隆溴铵逆转神经肌肉阻滞;3)0.2 mg·kg-1的潘库溴铵,结果CMRo2、CBF、ICP或EEG均无变化。B组犬(n = 6)也维持在0.86%的呼气末氟烷浓度,并依次接受以下处理:1)0.5 mg·kg-1的阿曲库铵;2)用新斯的明加格隆溴铵逆转神经肌肉阻滞;3)1.0 mg·kg-1的阿曲库铵;4)2.5 mg·kg-1的阿曲库铵。CMRo2、CBF或ICP均无变化;仅在一只接受最后一剂阿曲库铵的犬中出现了EEG显示的脑觉醒证据。C组犬(n = 6)接受丁卡因脊髓麻醉,并使用维持“麻醉”EEG模式的最低氟烷浓度(平均±标准误=呼气末0.69±0.03%)。C组的每只犬依次接受以下处理:1)1.0 mg·kg-1的阿曲库铵,2)2.5 mg·kg-1的阿曲库铵。所有六只C组犬均出现了EEG显示的脑觉醒证据。觉醒并未伴有CBF、CMRo2或ICP的显著增加。(摘要截取自250字)