Owall A, Gordon E, Lagerkranser M, Lindquist C, Rudehill A, Sollevi A
Anesth Analg. 1987 Mar;66(3):229-34.
The cardiovascular effects of adenosine-induced hypotension were studied in 47 patients undergoing intracranial vascular surgery under neurolept anesthesia. Adenosine infusion (214 +/- 18 micrograms X kg-1 X min-1) decreased mean arterial pressure (MAP) by 42 +/- 1% from 80 +/- 1 to 46 +/- 1 mm Hg for an average of 29 +/- 5 min of hypotension. Hypotension was associated with a minor increase in heart rate (13 +/- 2%) and with prolongation of the PR interval (9 +/- 2%). ST-T depression did not occur except in one patient with a previous history of myocardial infarction. The adenosine-induced increase in cardiac index (42 +/- 9%, n = 7) was associated with a 63 +/- 10% decrease in systemic vascular resistance index (n = 7) while the pulmonary capillary wedge pressure remained unchanged. Adenosine metabolism was limited and there was no accumulation of the end metabolite, uric acid. Serum creatinine levels were normal in all patients postoperatively. We conclude that adenosine rapidly induces a stable and easily controlled hypotension in man without tachyphylaxis or rebound hypertension. There were no signs of renal or myocardial dysfunction except for dysrhythmias that occurred in two patients with a history of myocardial infarction.
在47例接受神经安定麻醉下颅内血管手术的患者中，研究了腺苷诱导的低血压对心血管系统的影响。输注腺苷（214±18微克·千克⁻¹·分钟⁻¹）使平均动脉压（MAP）从80±1毫米汞柱降至46±1毫米汞柱，降低了42±1%，平均低血压持续29±5分钟。低血压伴有心率轻度增加（13±2%）和PR间期延长（9±2%）。除1例有心肌梗死病史的患者外，未出现ST-T段压低。腺苷诱导的心脏指数增加（42±9%，n = 7）与全身血管阻力指数降低63±10%（n = 7）相关，而肺毛细血管楔压保持不变。腺苷代谢有限，且终末代谢产物尿酸无蓄积。所有患者术后血清肌酐水平均正常。我们得出结论，腺苷能在人体迅速诱导出稳定且易于控制的低血压，无快速耐受性或反跳性高血压。除2例有心肌梗死病史的患者出现心律失常外，未发现肾脏或心肌功能障碍的迹象。
