Lehot J J, George M, Bastien O, Galliot J, Phuong L, Estanove S, Villard J
Hôpital Cardiovasculaire et Pneumologique Louis-Pradel, BP Lyon-Montchat.
Ann Fr Anesth Reanim. 1988;7(3):240-4. doi: 10.1016/S0750-7658(88)80118-7.
The vascular effects of nicergoline, a post-synaptic alpha receptor antagonist, were studied using a total haemodilution non pulsatile normothermic cardiopulmonary bypass with a bubble oxygenator during cardiac surgery. Anaesthesia was induced with fentanyl 30 micrograms.kg-1 and diazepam 0.25 mg.kg-1 and maintained with incremental doses of fentanyl. All the patients were intubated using pancuronium bromide (0.1 mg.kg-1) and artificially ventilated (FIO2 = 1). Nine patients randomly selected received 10 ml of saline (group 1) and 11 other 5 mg nicergoline (group 2) into the venous line of the extracorporeal circuit. Pump flow remained constant during 10 min. Arteriolar resistance was assessed by mean arterial pressure recording and venous capacitance by the level of venous reservoir. Statistical analysis was carried out using analysis of variance and the Newman-Keuls test. In group 1, arteriolar resistance increased by 17.0 +/- 21.8% at 10 min (not significant), whereas in group 2 it decreased by 22.8 +/- 8.1% at 2 min (p less than 0.05) and then increased slowly. It then remained 18% lower than in group 1 at 10 min. In group 1, venous capacitance decreased regularly by 1 ml.kg-1.min-1 during 10 min (-10.0 +/- 6.2 ml.kg-1 at 10 min), whereas in group 2 it decreased up to the 6th min (-4.2 +/- 3.3 ml.kg-1) and then remained stable, with a 5.4 ml.kg-1 difference with group 1 at 10 min (p less than 0.05). Therefore, nicergoline seemed to cause venoconstriction during cardiopulmonary bypass, possibly through a baroreflex mechanism.
在心脏手术期间，使用带鼓泡式氧合器的全血稀释非搏动常温体外循环，研究了突触后α受体拮抗剂尼麦角林的血管效应。用30微克/千克的芬太尼和0.25毫克/千克的地西泮诱导麻醉，并用递增剂量的芬太尼维持麻醉。所有患者均使用潘库溴铵（0.1毫克/千克）插管并进行人工通气（FIO2 = 1）。随机选择9名患者在体外循环静脉管路中注入10毫升生理盐水（第1组），另外11名患者注入5毫克尼麦角林（第2组）。泵流量在10分钟内保持恒定。通过平均动脉压记录评估小动脉阻力，通过静脉贮血器水平评估静脉容量。使用方差分析和纽曼 - 基尔斯检验进行统计分析。在第1组中，小动脉阻力在10分钟时增加了17.0±21.8%（无统计学意义），而在第2组中，在2分钟时下降了22.8±8.1%（p<0.05），然后缓慢上升。在10分钟时，其仍比第1组低18%。在第1组中，静脉容量在10分钟内以1毫升/千克·分钟的速率有规律地下降（10分钟时为-10.0±6.2毫升/千克），而在第2组中，其下降至第6分钟（-4.2±3.3毫升/千克），然后保持稳定，在10分钟时与第1组相差5.4毫升/千克（p<0.05）。因此，尼麦角林在体外循环期间似乎会引起静脉收缩，可能是通过压力反射机制。
