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脑血管二氧化碳反应性:麻醉调节的胆碱能机制的作用

Cerebrovascular CO2 reactivity: role of a cholinergic mechanism modulated by anesthesia.

作者信息

Scremin O U, Rubinstein E H, Sonnenschein R R

出版信息

Stroke. 1978 Mar-Apr;9(2):160-5. doi: 10.1161/01.str.9.2.160.

Abstract

Cerebral cortical blood flow was measured in rabbits with the hydrogen clearance technique. The reactivity to CO2, tested by changing the end tidal CO2 (ETCO2) in steps from 2 to 6 volumes %, was highly dependent on the kind of anesthesia, being greatest under halothane and least under nitrous oxide. Reactivity to CO2 in halothane-anesthetized animals also depended on arterial blood pressure, being greatest when pressure was below 70 mm Hg. Intravenous atropine blocked the increase in reactivity in halothane-anesthetized animals at low blood pressures. Conversely, intravenous eserine (physostigmine) greatly increased the reactivity to CO2 in nitrous oxide-anesthetized animals. Precollicular decerebration considerably decreased CO2 reactivity of halothane-anesthetized rabbits, while partial brain stem lesions that spared midline structures had no effect on CO2 reactivity. It is concluded that a central neurogenic mechanism with a cholinergic link may be responsible, at least in part, for the cerebrovascular effect of CO2. Moreover, the cerebrovascular effects of halothane may result from stimulation of the same system.

摘要

采用氢清除技术测量家兔大脑皮质血流量。通过将呼气末二氧化碳(ETCO2)从2%逐步改变至6%来测试对二氧化碳的反应性,该反应性高度依赖于麻醉类型,在氟烷麻醉下最大,在氧化亚氮麻醉下最小。氟烷麻醉动物对二氧化碳的反应性也取决于动脉血压,当血压低于70 mmHg时最大。静脉注射阿托品可阻断氟烷麻醉动物在低血压时反应性的增加。相反,静脉注射毒扁豆碱(physostigmine)可大大增加氧化亚氮麻醉动物对二氧化碳的反应性。中脑前脑去大脑术可显著降低氟烷麻醉家兔的二氧化碳反应性,而保留中线结构的部分脑干损伤对二氧化碳反应性无影响。得出的结论是,至少部分地,具有胆碱能联系的中枢神经源性机制可能是二氧化碳脑血管效应的原因。此外,氟烷的脑血管效应可能是由于对同一系统的刺激所致。

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