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氟烷对戊巴比妥麻醉犬膈肌功能的影响。

Effect of halothane on diaphragmatic muscle function in pentobarbital-anesthetized dogs.

作者信息

Clergue F, Viires N, Lemesle P, Aubier M, Viars P, Pariente R

出版信息

Anesthesiology. 1986 Feb;64(2):181-7. doi: 10.1097/00000542-198602000-00009.

Abstract

The mechanism underlying the decrease in minute ventilation (VE) observed under halothane anesthesia was investigated in nine spontaneously breathing dogs. Anesthesia was induced with pentobarbital sodium and was maintained with halothane. Inspired fraction of halothane (FIhal) was increased every 30 min, from 0.005 to 0.02. VE decreased from 8.1 +/- 0.9 to 4.8 +/- 0.4 l . min-1 (P less than 0.001), as FIhal increased from 0 to 0.02. This resulted from a decrease in both mean inspiratory flow (VT/TI) and the duty ratio (TI/TTOT). Transdiaphragmatic pressure (Pdi) and the integrated electrical activity of both hemidiaphragms (Edi) were measured during normal breathing, and during breathing against closed airways (P0di, E0di), in order to obtain an index of the inspiratory neuromuscular output of the diaphragm. With increasing FIhal, there was a significant decrease in Pdi, P0di, Edi, and E0di. The authors measured Pdi and Edi generated during supramaximal stimulation of the two phrenic nerves (PSdi, Esdi) at frequencies of 10, 20, 50, and 100 Hz, in order to eliminate in this decrease the role played by a decrease in the neural drive to breathing. PSdi and ESdi decreased significantly with increasing FIhal, and had not returned to the control values 30 min after discontinuation of halothane administration. The authors conclude that, in pentobarbital-anesthetized dogs, halothane is responsible for a diaphragmatic dysfunction, which may be located either at the neuromuscular junction, on the contractile processes of the muscle, or on both, and for a decrease in the activation time of the inspiratory muscles. Both of these effects contribute to the decrease in VE observed under halothane anesthesia.

摘要

在9只自主呼吸的犬中研究了氟烷麻醉下观察到的分钟通气量(VE)降低的潜在机制。用戊巴比妥钠诱导麻醉并用氟烷维持。每隔30分钟将氟烷的吸入分数(FIhal)从0.005增加到0.02。随着FIhal从0增加到0.02,VE从8.1±0.9降至4.8±0.4升·分钟-1(P<0.001)。这是由于平均吸气流量(VT/TI)和占空比(TI/TTOT)均降低所致。在正常呼吸期间以及在对抗闭合气道呼吸时(P0di,E0di)测量跨膈压(Pdi)和双侧膈肌的综合电活动(Edi),以便获得膈肌吸气神经肌肉输出的指标。随着FIhal增加,Pdi、P0di、Edi和E0di均显著降低。作者测量了在10、20、50和100Hz频率下双侧膈神经超最大刺激时产生的Pdi和Edi(PSdi,Esdi),以便在这种降低中消除呼吸神经驱动降低所起的作用。随着FIhal增加,PSdi和ESdi显著降低,并且在停止给予氟烷30分钟后未恢复到对照值。作者得出结论,在戊巴比妥麻醉的犬中,氟烷导致膈肌功能障碍,其可能位于神经肌肉接头处、肌肉的收缩过程中或两者均有,并且导致吸气肌激活时间缩短。这两种效应均导致氟烷麻醉下观察到的VE降低。

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