Heinrich H, Fontaine L, Fösel T, Spilker D, Winter H, Ahnefeld F W
Anaesthesist. 1986 Aug;35(8):465-72.
Using the afterload-independent end-systolic pressure-dimension-relationship a study was performed in order to investigate whether there are differences in the negative inotropic effects of halothane, enflurane and isoflurane at 1 MAC in 70% N2O. 30 patients of ASA-groups I and II were studied. Using transoesophageal 2d- and m-mode echocardiography the end-systolic-pressure-dimension-relationship was established and the slope (parameter of contractility) determined. The slope decreased significantly (paired Wilcoxon-test 2 alpha less than 0.01) with halothane (68.5/46.5 mmHg/cm), enflurane (56/48 mm Hg/cm) and isoflurane (63/35 mmHg/cm). There is no difference between the three groups (Kruskal-Wallis-test 2 alpha greater than 0.05). The negative inotropic effects of halothane, enflurane and isoflurane at 1 MAC in 70% N2O are the same. The vasodilation caused by isoflurane enables better pump function compared to halothane and enflurane, but may cause severe hypotension. We conclude that for cardiac risk patients isoflurane has no outstanding advantages in comparison to halothane and enflurane.
利用后负荷无关的收缩末期压力-维度关系进行了一项研究，以调查在70%氧化亚氮中1个最低肺泡有效浓度时，氟烷、恩氟烷和异氟烷的负性肌力作用是否存在差异。研究了30例ASA I级和II级患者。使用经食管二维和M型超声心动图建立收缩末期压力-维度关系并确定斜率（收缩性参数）。氟烷（68.5/46.5 mmHg/cm）、恩氟烷（56/48 mmHg/cm）和异氟烷（63/35 mmHg/cm）使斜率显著降低（配对Wilcoxon检验，双侧α小于0.01）。三组之间无差异（Kruskal-Wallis检验，双侧α大于0.05）。在70%氧化亚氮中1个最低肺泡有效浓度时，氟烷、恩氟烷和异氟烷的负性肌力作用相同。与氟烷和恩氟烷相比，异氟烷引起的血管舒张可使泵功能更好，但可能导致严重低血压。我们得出结论，对于心脏风险患者，与氟烷和恩氟烷相比，异氟烷没有突出优势。
