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氨力农对氟烷麻醉犬的血流动力学影响:与异丙肾上腺素和多巴酚丁胺的比较。

Hemodynamic effects of amrinone in dogs anesthetized with halothane: comparison with isoproterenol and dobutamine.

作者信息

Boncyk J, Redon D, Rusy B

出版信息

Res Commun Chem Pathol Pharmacol. 1984 Jun;44(3):347-54.

PMID:6463363
Abstract

Baseline hemodynamic variables were established during morphine - N2O-O2 anesthesia in dogs following which N2O was discontinued and halothane 2% (end-tidal) in O2 was administered. Halothane caused significant decreases of 58, 55, and 66 percent, respectively, in cardiac output, mean arterial pressure, and left ventricular dP/dt and significantly increased pulmonary vascular resistance (161%) when compared to measurements obtained under morphine - N2O-O2 anesthesia. During halothane anesthesia, amrinone, isoproterenol, and dobutamine were administered by continuous intravenous infusion in doses which restored cardiac output to pre-halothane values. Left ventricular dP/dt was increased and pulmonary resistance was decreased significantly by the three positive inotropic agents. Isoproterenol and amrinone significantly decreased systemic vascular resistance 48 and 71 percent, respectively below the value for halothane alone. Dobutamine significantly increased mean arterial pressure. Heart rate and left ventricular end-diastolic pressure were not altered by any treatment. Ventricular arrhythmias were associated with the infusion of all three agents. It is concluded that amrinone, isoproterenol, and dobutamine were capable of restoring cardiac output which had been decreased by halothane. However, isoproterenol and amrinone caused marked decreases in systemic vascular resistance which precluded an increase in arterial pressure above the value encountered with halothane alone.

摘要

在犬吗啡 - 氧化亚氮 - 氧气麻醉期间测定基础血流动力学变量,随后停用氧化亚氮并给予2%(呼气末)的氟烷与氧气混合气体。与吗啡 - 氧化亚氮 - 氧气麻醉下的测量值相比,氟烷使心输出量、平均动脉压和左心室dp/dt分别显著降低58%、55%和66%,并使肺血管阻力显著增加(161%)。在氟烷麻醉期间,氨力农、异丙肾上腺素和多巴酚丁胺通过持续静脉输注给药,剂量可使心输出量恢复到氟烷麻醉前的值。这三种正性肌力药物显著增加了左心室dp/dt并降低了肺血管阻力。异丙肾上腺素和氨力农分别使体循环血管阻力比单独使用氟烷时显著降低48%和71%。多巴酚丁胺显著增加了平均动脉压。任何治疗均未改变心率和左心室舒张末期压力。所有三种药物的输注均与室性心律失常有关。结论是,氨力农、异丙肾上腺素和多巴酚丁胺能够恢复因氟烷而降低的心输出量。然而,异丙肾上腺素和氨力农使体循环血管阻力显著降低,这使得动脉压无法升高至单独使用氟烷时的水平之上。

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