Ghignone M, Calvillo O, Quintin L, Caple S, Kozody R
Can J Anaesth. 1987 Jan;34(1):46-50. doi: 10.1007/BF03007681.
The haemodynamic effects of clonidine administered in the epidural space were studied in 16 halothane-anaesthetized dogs. The animals were randomly assigned to two groups: Group I received three doses of 3 ml of normal saline, Group II received three doses of 3 micrograms X kg-1 of clonidine, through an epidural catheter, whose tip was located between L2-T11. Control haemodynamic measurements were taken one hour after completion of the surgical preparation (period P1); they were repeated every 45 minutes after each incremental dose (periods P2, P3, P4) and 105 minutes after a total cumulative dose of 9 micrograms X kg-1 of clonidine or 9 ml of saline were given (period P5). No significant changes over time were observed in Group I. In Group II clonidine produced statistically significant reductions of systemic blood pressure (BP), mean left ventricular pressure (LV), heart rate (HR), cardiac output (CO) and peak LV dP/dt only after a total clonidine dose of 9 micrograms X kg-1 and these changes were sustained. BP fell 15 per cent, CO 21 per cent, HR 25 per cent, LV 20 per cent and peak LV dP/dt 30 per cent when P5 measurements were compared to control values within Group II (p less than 0.05). These haemodynamic effects of clonidine are likely due to minimal systemic absorption and/or cephalad spread of the drug towards its site of action in the brain stem. The reductions of HR, CO, BP, and isovolemic indices of contractility are likely explained by a reduction of sympathetic outflow at the spinal cord and medulla oblongata levels as well as increased parasympathetic tone.(ABSTRACT TRUNCATED AT 250 WORDS)
在16只接受氟烷麻醉的犬中研究了硬膜外给予可乐定的血流动力学效应。动物被随机分为两组:第一组通过硬膜外导管(导管尖端位于L2 - T11之间)接受3剂3毫升生理盐水,第二组接受3剂3微克/千克的可乐定。在手术准备完成后1小时进行对照血流动力学测量(P1期);在每次递增剂量后每45分钟重复测量(P2、P3、P4期),在给予总量为9微克/千克的可乐定或9毫升生理盐水后105分钟重复测量(P5期)。第一组未观察到随时间的显著变化。在第二组中,仅在可乐定总剂量达到9微克/千克后,可乐定才使全身血压(BP)、平均左心室压力(LV)、心率(HR)、心输出量(CO)和左心室dP/dt峰值出现统计学显著降低,且这些变化持续存在。与第二组内的对照值相比,P5期测量时BP下降15%,CO下降21%,HR下降25%,LV下降20%,左心室dP/dt峰值下降30%(p < 0.05)。可乐定的这些血流动力学效应可能是由于药物全身吸收极少和/或向脑干作用部位的头向扩散。HR、CO、BP和等容收缩性指标的降低可能是由于脊髓和延髓水平的交感神经传出减少以及副交感神经张力增加所致。(摘要截短至250字)