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间羟异丙肾上腺素、异丙喘宁和沙丁胺醇对犬乙酰甲胆碱诱发支气管痉挛缓解作用的比较。

Comparison of metaproterenol, isoetharine and salbutamol in the relief of methacholine-induced bronchospasm in dogs.

作者信息

Casthely P A, Cottrell J E, Urquhart P A

出版信息

Can Anaesth Soc J. 1985 Mar;32(2):112-8. doi: 10.1007/BF03010033.

Abstract

We evaluated cardiovascular effects and effectiveness of isoetharine, metaproterenol and salbutamol, when administered intratracheally to relieve methacholine-induced bronchospasm in dogs anaesthetized with 50 per cent nitrous oxide, oxygen, halothane and mechanically ventilated. Methacholine 2 micrograms X kg-1 X hour-1 was administrated first followed by halothane (1 MAC) for 30 minutes (control), then metaproterenol, isoetharine or salbutamol. Metaproterenol (15 mg) significantly decreased transpulmonary pressure to 20.1 +/- 0.5 (SE) from 22.5 +/- 1.15 cmH2O (p less than 0.025) after three min and to 15 +/- 0.5 cmH2O (p less than 0.005) after 90 min. Isoetharine (2.5 mg) decreased transpulmonary pressure after five min to 22.1 +/- 1 from 24.5 +/- 1.5 cmH2O (p less than 0.05), and to 21.75 +/- 0.55 mmH2O after 90 min. Salbutamol 25 micrograms X kg-1 decreased transpulmonary pressure to 20.7 +/- 0.75 from 24.25 +/- 1.28 after three min and to 16 +/- .5 after 90 min. The peak effects on airway pressure occurred at 15 min for metaproterenol, 25 min for salbutamol and 20 min for isoetharine. Pulmonary vascular resistance was not significantly changed during halothane anaesthesia alone but decreased significantly after metaproterenol and isoetharine infusion. Heart rate increased ten per cent after metaproterenol, three per cent after isoetharine, and five per cent after salbutamol. No arrhythmias occurred in any group. Cardiac output increased significantly to 3.25 +/- 0.2 from 1.5 +/- 0.17 L X min-1 (p less than 0.025) after metaproterenol to 3.2 +/- .025 from 1.45 +/- .009 after salbutamol and was unchanged after isoetharine. Metaproterenol and salbutamol in the presence of 1 MAC halothane anaesthesia relieved methacholine-induced bronchospasm more rapidly than did isoetharine. The onset of effect was 3 +/- 0.05 min for metaproterenol and salbutamol and 5 +/- 0.01 min for isoetharine. The effect lasted 210 +/- 10.5 min for metaproterenol, 170 +/- 12.5 min for salbutamol and 90 +/- 4.75 min for isoetharine.

摘要

我们评估了异丙喘宁、间羟异丙肾上腺素和沙丁胺醇经气管内给药,以缓解在使用50%氧化亚氮、氧气、氟烷麻醉并机械通气的犬中,由乙酰甲胆碱诱发的支气管痉挛时的心血管效应及有效性。首先给予2微克/千克/小时的乙酰甲胆碱,随后给予氟烷(1个最低肺泡有效浓度)30分钟(对照),然后给予间羟异丙肾上腺素、异丙喘宁或沙丁胺醇。间羟异丙肾上腺素(15毫克)在3分钟后使跨肺压从22.5±1.15厘米水柱显著降至20.1±0.5(标准误)(p<0.025),90分钟后降至15±0.5厘米水柱(p<0.005)。异丙喘宁(2.5毫克)在5分钟后使跨肺压从24.5±1.5厘米水柱降至22.1±1(p<0.05),90分钟后降至21.75±0.55毫米水柱。25微克/千克的沙丁胺醇在3分钟后使跨肺压从24.25±1.28降至20.7±0.75,90分钟后降至16±0.5。间羟异丙肾上腺素对气道压力的峰值效应出现在15分钟,沙丁胺醇出现在25分钟,异丙喘宁出现在20分钟。单独使用氟烷麻醉期间肺血管阻力无显著变化,但在输注间羟异丙肾上腺素和异丙喘宁后显著降低。间羟异丙肾上腺素使心率增加10%,异丙喘宁使心率增加3%,沙丁胺醇使心率增加5%。任何组均未发生心律失常。间羟异丙肾上腺素使心输出量从1.5±0.17升/分钟显著增加至3.25±0.2(p<0.025),沙丁胺醇使心输出量从1.45±0.009增加至3.2±0.025,异丙喘宁后心输出量无变化。在1个最低肺泡有效浓度氟烷麻醉下,间羟异丙肾上腺素和沙丁胺醇比异丙喘宁更迅速地缓解了乙酰甲胆碱诱发的支气管痉挛。间羟异丙肾上腺素和沙丁胺醇的起效时间为3±0.05分钟,异丙喘宁为5±0.01分钟。间羟异丙肾上腺素的作用持续210±10.5分钟,沙丁胺醇为170±12.5分钟,异丙喘宁为90±4.75分钟。

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