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硬膜外可乐定不会降低清醒绵羊的血压或脊髓血流量。

Epidural clonidine does not decrease blood pressure or spinal cord blood flow in awake sheep.

作者信息

Eisenach J C, Grice S C

机构信息

Department of Anesthesia, Wake Forest University, Bowman Gray School of Medicine, Winston-Salem, North Carolina 27103.

出版信息

Anesthesiology. 1988 Mar;68(3):335-40. doi: 10.1097/00000542-198803000-00003.

Abstract

Preliminary data in animals and humans suggest that epidurally administered clonidine produces antinociception and is not neurotoxic. However, clonidine can produce vasoconstriction, and epidurally administered clonidine decreases spinal cord blood flow in anesthetized pigs. To examine the effect of epidurally administered clonidine on spinal cord blood flow in awake animals, the authors inserted lumbar epidural, femoral arterial and venous, pulmonary arterial, and left ventricular catheters in 13 adult sheep. Following a 24-h recovery, the authors injected saline (N = 6) or clonidine, 750 micrograms (17-25 micrograms/kg; N = 7) epidurally, and measured arterial blood gas tensions; temperature; heart rate; systemic and pulmonary arterial, right atrial, and pulmonary capillary wedge pressures; and spinal cord and renal blood flows (by radioactive microsphere injection) before and at 45 min and 4 h following injection. Epidural saline injection did not affect measured variables. Heart rate decreased from 112 +/- 9 to 86 +/- 4 beats/min (mean +/- SE; P = .003) and arterial PO2 decreased from 99 +/- 3 to 78 +/- 6 mmHg (P = .04) 45 min following clonidine injection. Temperature increased from 39.1 +/- .2 to 40.6 +/- 1 degree C (P = .0001) 4 h following clonidine injection. Epidural clonidine administration did not affect cardiac output, pulmonary and systemic pressures, or renal or spinal cord blood flows, except for an increase in mid-thoracic spinal cord blood flow 45 min following injection. The authors conclude that, in sheep, epidural clonidine does not produce dangerous cardiovascular depression or global spinal cord ischemia.

摘要

动物和人体的初步数据表明,硬膜外给予可乐定可产生镇痛作用且无神经毒性。然而,可乐定可引起血管收缩,硬膜外给予可乐定可使麻醉猪的脊髓血流量减少。为了研究硬膜外给予可乐定对清醒动物脊髓血流量的影响,作者在13只成年绵羊身上插入了腰段硬膜外导管、股动脉和静脉导管、肺动脉导管以及左心室导管。在恢复24小时后,作者硬膜外注射生理盐水(N = 6)或750微克可乐定(17 - 25微克/千克;N = 7),并在注射前、注射后45分钟和4小时测量动脉血气张力、体温、心率、体循环和肺动脉、右心房以及肺毛细血管楔压,以及脊髓和肾血流量(通过放射性微球注射)。硬膜外注射生理盐水对所测变量无影响。可乐定注射后45分钟,心率从112±9次/分钟降至86±4次/分钟(平均值±标准误;P = .003),动脉血氧分压从99±3毫米汞柱降至78±6毫米汞柱(P = .04)。可乐定注射后4小时,体温从39.1±.2摄氏度升至40.6±1摄氏度(P = .0001)。硬膜外给予可乐定除了在注射后45分钟使胸段脊髓中段血流量增加外,对心输出量、肺和体循环压力或肾或脊髓血流量均无影响。作者得出结论,在绵羊中,硬膜外给予可乐定不会产生危险的心血管抑制或全脊髓缺血。

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