Motomura S, Kissin I, Aultman D F, Reves J G
Anesth Analg. 1984 Jan;63(1):47-50.
The effects of fentanyl, nitrous oxide, and their combination on myocardial contractility were investigated in the papillary muscle preparation perfused by a donor dog. With a conscious donor, fentanyl infused directly into the arterial blood perfusing the papillary muscle produced a dose-related depression of developed tension. However, blood concentrations of fentanyl required to obtain the depression were in the range of 30-120 micrograms/ml. The ED50 for fentanyl for suppression of papillary muscle contractility was 89 +/- 9 micrograms/ml. When the donor dog was given nitrous oxide (N2O,80% and O2,20%), the developed tension of the papillary muscle decreased 25 +/- 5%. Fentanyl administered during nitrous oxide anesthesia caused a decrease in developed tension that was not significantly different from that obtained without N2O anesthesia (18 +/- 4% vs 13 +/- 4% for 30 micrograms/ml, and 61 +/- 5% vs 58 +/- 4% for 100 micrograms/ml). The results suggest that fentanyl produces a direct negative inotropic effect only in concentrations that are 2-3 orders of magnitude higher than its blood concentrations in fentanyl-induced anesthesia. When fentanyl and nitrous oxide are used together their interaction is not significantly different from additive.
在由供体犬灌注的乳头肌标本中,研究了芬太尼、氧化亚氮及其组合对心肌收缩力的影响。对于清醒的供体,直接注入灌注乳头肌的动脉血中的芬太尼可产生与剂量相关的张力降低。然而,产生这种降低所需的芬太尼血药浓度在30 - 120微克/毫升范围内。芬太尼抑制乳头肌收缩力的ED50为89±9微克/毫升。当给供体犬吸入氧化亚氮(N2O,80%和O2,20%)时,乳头肌的张力降低25±5%。在氧化亚氮麻醉期间给予芬太尼会导致张力降低,这与未使用N2O麻醉时获得的降低没有显著差异(30微克/毫升时分别为18±4%和13±4%,100微克/毫升时分别为61±5%和58±4%)。结果表明,芬太尼仅在比其在芬太尼诱导麻醉中的血药浓度高2 - 3个数量级的浓度下才产生直接的负性肌力作用。当芬太尼和氧化亚氮一起使用时,它们的相互作用与相加作用没有显著差异。