Modig J
Department of Anesthesiology and Intensive Care, University Hospital of Uppsala, Sweden.
Eur Surg Res. 1988;20(3):195-204. doi: 10.1159/000128761.
Chlormethiazole, which is derived from the thiazole moiety of thiamine, possesses sedative, hypnotic and anticonvulsant properties. This anesthetic agent was compared with ketamine in a porcine model of endotoxemia to evaluate effects on cardiovascular and pulmonary function, oxygen delivery and survival. Continuous 6-hour intravenous infusion of Escherichia coli endotoxin caused pronounced pulmonary and cardiovascular derangement and decreases in oxygen delivery and pH in 13 pigs given ketamine anesthesia. Eight of thirteen pigs survived the observation period. Contrastingly, 10 pigs given chlormethiazole anesthesia and endotoxin showed a significantly attenuated response. Thus, the increases in mean pulmonary arterial pressure, venous admixture and extravascular lung water were significantly lower and the decreases in cardiac output, oxygen delivery and pH were significantly modified by chlormethiazole. All 10 pigs survived the observation period. Chlormethiazole may increase the clearance of endotoxin and thus ameliorate the endotoxin response. Although extrapolating from animal data requires great caution, these data may favor the use of chlormethiazole in septic states requiring surgical intervention and anesthesia and as sedation in critically ill septic patients in our intensive care units.
氯美噻唑由硫胺素的噻唑部分衍生而来，具有镇静、催眠和抗惊厥特性。在猪内毒素血症模型中，将这种麻醉剂与氯胺酮进行比较，以评估其对心血管和肺功能、氧输送及存活率的影响。连续6小时静脉输注大肠杆菌内毒素，在13只接受氯胺酮麻醉的猪中引起了明显的肺和心血管紊乱，以及氧输送和pH值下降。13只猪中有8只存活至观察期结束。相比之下，10只接受氯美噻唑麻醉并注射内毒素的猪反应明显减轻。因此，氯美噻唑显著降低了平均肺动脉压、静脉血掺杂和血管外肺水的增加幅度，并显著改善了心输出量、氧输送和pH值的下降情况。所有10只猪均存活至观察期结束。氯美噻唑可能会增加内毒素的清除率，从而改善内毒素反应。尽管从动物数据外推需格外谨慎，但这些数据可能支持在需要手术干预和麻醉的脓毒症状态下，以及在我们重症监护病房的重症脓毒症患者镇静治疗中使用氯美噻唑。
