Sivarajan M, Amory D W, McKenzie S M
Anesth Analg. 1985 Aug;64(8):759-66.
In monkeys anesthetized with 70% nitrous oxide and 0.5% inspired halothane in oxygen, we measured changes in systemic hemodynamics and regional blood flows produced by nitroprusside and trimethaphan. Regional blood flow measurements were made using the radioactive microsphere technique. Control measurements were made before infusion of nitroprusside and trimethaphan into each animal in sequence in amounts adequate to reduce mean arterial pressure to approximately 55 +/- 5 mm Hg. Measurements were made during each drug infusion after a stable period of hypotension lasting at least 30 min. During nitroprusside infusion, cerebral blood flow remained unchanged, but myocardial blood flow increased significantly. However, pressure-rate product, an indirect measure of myocardial oxygen consumption, was unchanged, implying that myocardial blood flow exceeded myocardial oxygen requirement. During trimethaphan infusion, cerebral blood flow decreased, although cerebral metabolic rate for oxygen was unchanged due to increased oxygen extraction by the brain. Trimethaphan also produced a decrease in myocardial blood flow that was in proportion to the decrease in myocardial oxygen requirement as indicated by pressure-rate product. Neither drug produced changes in renal or total hepatic blood flows. We conclude that brain oxygen reserve is decreased during hypotension induced by trimethaphan. Blood flows to other organs are not significantly impaired in monkeys during hypotension to a mean arterial pressure of approximately 55 mm Hg induced by either nitroprusside or trimethaphan.
在使用70%氧化亚氮和0.5%吸入氟烷加氧气麻醉的猴子身上,我们测量了硝普钠和三甲噻芬引起的全身血流动力学和局部血流变化。局部血流测量采用放射性微球技术。在向每只动物依次输注足以将平均动脉压降至约55±5mmHg的硝普钠和三甲噻芬之前进行对照测量。在至少持续30分钟的稳定低血压期后的每种药物输注期间进行测量。在输注硝普钠期间,脑血流量保持不变,但心肌血流量显著增加。然而,作为心肌氧消耗间接指标的压力-心率乘积未变,这意味着心肌血流量超过了心肌需氧量。在输注三甲噻芬期间,脑血流量减少,尽管由于大脑增加了氧摄取,脑氧代谢率未变。三甲噻芬还使心肌血流量减少,这与压力-心率乘积所示的心肌需氧量减少成比例。两种药物均未引起肾或肝脏总血流量的变化。我们得出结论,在三甲噻芬诱导的低血压期间脑氧储备减少。在硝普钠或三甲噻芬诱导平均动脉压降至约55mmHg的低血压期间,猴子的其他器官血流未受到明显损害。