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一种用于研究血流与药物处置之间相互作用的绵羊实验准备。第六部分:全身麻醉或蛛网膜下腔麻醉对血流和氯美噻唑处置的影响。

A sheep preparation for studying interactions between blood flow and drug disposition. VI: Effects of general or subarachnoid anaesthesia on blood flow and chlormethiazole disposition.

作者信息

Runciman W B, Mather L E, Ilsley A H, Carapetis R J, Upton R N

出版信息

Br J Anaesth. 1986 Nov;58(11):1308-16. doi: 10.1093/bja/58.11.1308.

Abstract

Blood flow through and chlormethiazole extraction ratios across lungs, liver, kidneys and gut were measured in awake unrestrained sheep (controls) and with the same animals anaesthetized with 1.5% halothane or whilst undergoing high thoracic subarachnoid blockade with amethocaine. In the control-drug studies, chlormethiazole infused to sub-sedative blood concentrations produced no significant changes in haemodynamics or in the kinetics of iodohippurate (renal and hepatic blood flows). Chlormethiazole was eliminated predominantly by the liver (mean extraction ratio and clearance, respectively, 0.90 and 1.3 litre min-1) and lungs (0.15; 0.6 litre min-1). Renal clearance was absent or negligible (greater than 0.1 litre min-1). Because of pulmonary clearance, mean total body clearance was derived from analysis of pulmonary arterial concentrations. Under general anaesthesia, there were significant reductions in mean cardiac output, hepatic and renal blood flow (to 54%, 63% and 43% of control); chlormethiazole mean hepatic extraction ratios and clearance were reduced, respectively, to 82% and 56% of control, and its pulmonary and renal clearances were abolished. With subarachnoid anaesthesia there were no significant changes in haemodynamics or in chlormethiazole extraction ratios or clearances.

摘要

在清醒无拘束的绵羊(对照组)以及用1.5%氟烷麻醉的同一只绵羊或用丁卡因进行高位胸段蛛网膜下腔阻滞的绵羊中,测量了流经肺、肝、肾和肠道的血流量以及氯美噻唑在这些器官中的提取率。在对照药物研究中,输注至亚镇静血药浓度的氯美噻唑对血流动力学或碘马尿酸盐动力学(肾和肝血流量)没有显著影响。氯美噻唑主要通过肝脏(平均提取率和清除率分别为0.90和1.3升/分钟)和肺(0.15;0.6升/分钟)清除。肾清除率不存在或可忽略不计(大于0.1升/分钟)。由于肺清除,平均全身清除率通过分析肺动脉浓度得出。在全身麻醉下,平均心输出量、肝血流量和肾血流量显著降低(分别降至对照值的54%、63%和43%);氯美噻唑的平均肝提取率和清除率分别降至对照值的82%和56%,其肺清除率和肾清除率消失。蛛网膜下腔麻醉时,血流动力学、氯美噻唑提取率或清除率无显著变化。

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