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氧化亚氮或氟烷对低血容量猪的心血管作用。

Cardiovascular actions of nitrous oxide or halothane in hypovolemic swine.

作者信息

Weiskopf R B, Bogetz M S

出版信息

Anesthesiology. 1985 Nov;63(5):509-16. doi: 10.1097/00000542-198511000-00006.

DOI:10.1097/00000542-198511000-00006
PMID:3901822
Abstract

During normovolemia, nitrous oxide causes mild sympathetic stimulation and direct myocardial depression; these effects offset each other, resulting in only minimal cardiovascular changes. To test the hypothesis that during hypovolemia this balance would change and depression predominate, 10 swine were made hypovolemic (30% blood loss) and then were given 70% N2O (0.25 MAC in swine) or an equipotent concentration of halothane, an agent that does not cause sympathetic stimulation. The alternate anesthetic was given to the same hypovolemic swine on another day. Five minutes after induction of anesthesia during hypovolemia, both N2O and halothane caused significant, physiologically important deterioration of compensation for hemorrhage. Halothane decreased systemic vascular resistance (SVR); N2O was more variable in its action, and SVR did not decrease significantly. Both agents caused similar decreases in cardiac output, mean aortic blood pressure, stroke volume, oxygen consumption, and left ventricular minute work, despite increases in plasma epinephrine concentration and plasma renin activity. No differences were found between groups for any of these variables (P greater than 0.05). Plasma norepinephrine concentration increased only in the N2O group and was greater in that group than in the halothane group. The deterioration of cardiovascular compensation for hemorrhage was expressed metabolically by similar decreases in the two groups in partial pressure of oxygen of mixed venous blood and by increases in blood lactate concentration. Thirty minutes after induction of anesthesia, with stable end-tidal anesthetic concentrations, both groups had some cardiovascular, but no metabolic, recovery.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

在血容量正常时,氧化亚氮会引起轻度的交感神经兴奋和直接的心肌抑制;这些作用相互抵消,仅导致极小的心血管变化。为了验证在低血容量时这种平衡会改变且抑制作用占主导的假说,对10头猪造成低血容量(失血30%),然后给予70%的氧化亚氮(猪的0.25最低肺泡有效浓度)或等效浓度的氟烷,氟烷是一种不会引起交感神经兴奋的药物。在另一天给同一批低血容量的猪使用另一种麻醉药。在低血容量时诱导麻醉5分钟后,氧化亚氮和氟烷均导致对出血代偿的显著且具有生理重要性的恶化。氟烷降低了全身血管阻力(SVR);氧化亚氮的作用更具变异性,SVR没有显著降低。尽管血浆肾上腺素浓度和血浆肾素活性增加,但两种药物均使心输出量、平均主动脉血压、每搏量、氧耗量和左心室每分钟功出现相似程度的下降。两组在这些变量中的任何一项上均未发现差异(P大于0.05)。仅氧化亚氮组的血浆去甲肾上腺素浓度升高,且该组高于氟烷组。两组混合静脉血氧分压的相似下降以及血乳酸浓度的升高在代谢方面体现了出血时心血管代偿功能的恶化。麻醉诱导30分钟后,在呼气末麻醉浓度稳定的情况下,两组均有一定程度的心血管恢复,但代谢方面未恢复。(摘要截断于250字)

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引用本文的文献

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2
Summary of the scientific literature for pain and anxiety control in dentistry. Journal literature, January-December, 1985.牙科疼痛与焦虑控制的科学文献综述。期刊文献,1985年1月至12月。
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