Damask M C, Weissman C, Rodriguez J, Askanazi J, Rosenbaum S H, Hyman A I
Arch Surg. 1984 Nov;119(11):1332-7. doi: 10.1001/archsurg.1984.01390230098025.
We address the question of whether an oxygen debt develops during a period of abdominal aortic cross-clamping that may explain observed hemodynamic changes. Group 1 received morphine sulfate (1 mg/kg) during induction of anesthesia. Group 2 received same dose of morphine sulfate. Group 3 received 4 mg/kg of morphine sulfate. We measured the oxygen consumption (VO2) and the carbon dioxide production levels (VCO2), as well as hemodynamic and biochemical parameters. In groups 1 and 3, VO2 and VCO2 decreased 10% to 13% following abdominal aortic cross-clamping compared with values measured before cross-clamping. In group 2, VO2 and VCO2 decreased 3% and 7%, respectively. On unclamping, the greatest increase in VO2 was observed in group 3 (26%), while in groups 1 and 2, VO2 rose 18% and 5%, respectively. In all three groups, metabolic changes were not paralleled by hemodynamic or temperature changes. Results indicate that oxygen debt developed during abdominal aortic cross-clamping, but this has no effect on hemodynamic changes seen after unclamping. Higher dosage of narcotic administered during anesthetic induction did not temper increase in metabolic rate observed after unclamping.
我们探讨了在腹主动脉交叉钳夹期间是否会产生氧债的问题，这可能解释所观察到的血流动力学变化。第一组在麻醉诱导期间接受硫酸吗啡（1毫克/千克）。第二组接受相同剂量的硫酸吗啡。第三组接受4毫克/千克的硫酸吗啡。我们测量了氧耗量（VO2）、二氧化碳产生水平（VCO2）以及血流动力学和生化参数。在第一组和第三组中，与腹主动脉交叉钳夹前测量的值相比，钳夹后VO2和VCO2下降了10%至13%。在第二组中，VO2和VCO2分别下降了3%和7%。松开钳夹后，第三组观察到VO2的最大增幅（26%），而在第一组和第二组中，VO2分别上升了18%和5%。在所有三组中，代谢变化与血流动力学或温度变化并不平行。结果表明，腹主动脉交叉钳夹期间产生了氧债，但这对松开钳夹后所见的血流动力学变化没有影响。麻醉诱导期间给予较高剂量的麻醉剂并不能缓和松开钳夹后观察到的代谢率增加。
