Gronert G A, Michenfelder J D, Steen P A, Milde J H
Anesthesiology. 1983 Jan;58(1):18-25. doi: 10.1097/00000542-198301000-00004.
The impact of tolerance on the metabolism of the whole body, skeletal muscle, brain, kidneys, splanchnic region, and heart during prolonged pentobarbital anesthesia was evaluated in 80 dogs. Oxygen consumption (VO2) for each organ system and whole body was calculated from measured blood flow rate and the difference in blood oxygen content between arterial and venous blood during four periods of continuous and unvarying deep pentobarbital anesthesia: 0-3 h, 3-6 h, 12-15 h, and 21-24 h. VO2 increased with time in whole body (12%), gastrocnemius muscle (83%), calculated entire skeletal muscle (15%), brain (27%), kidneys (20%), and splanchnic area (10%); it decreased in the heart (20%). In all studies, the electroencephalogram indicated a constant deep burst-suppression level of 2-6 bursts/min and blood pentobarbital levels ranged from 4.5-6 mg/dl. About one-fifth of the increase in gastrocnemius VO2 could be accounted for by the effect of a continuous infusion of succinylcholine, and about two-thirds of the rise in renal VO2 by increased renal function. The decrease in heart VO2 was associated with increased cardiac output and decreased systemic vascular resistance. The sustained increase in metabolism was significant and otherwise unexplained in whole body, skeletal muscle, and the brain; it occurred after 3 h had continued through 24 h of pentobarbital anesthesia. This was presumably due to tolerance, and was manifested as increased metabolism during steady deep anesthesia with unchanged blood levels of pentobarbital rather than as a greater requirement for pentobarbital.
在80只犬中评估了长时间戊巴比妥麻醉期间耐受性对全身、骨骼肌、脑、肾、内脏区域和心脏代谢的影响。在持续且深度不变的戊巴比妥麻醉的四个阶段：0 - 3小时、3 - 6小时、12 - 15小时和21 - 24小时，根据测得的血流速率以及动脉血和静脉血之间的血氧含量差异，计算每个器官系统和全身的耗氧量（VO₂）。全身（12%）、腓肠肌（83%）、计算得出的整个骨骼肌（15%）、脑（27%）、肾（20%）和内脏区域（10%）的VO₂随时间增加；心脏的VO₂下降（20%）。在所有研究中，脑电图显示持续的深度爆发抑制水平为2 - 6次/分钟，血液戊巴比妥水平在4.5 - 6mg/dl范围内。腓肠肌VO₂增加的约五分之一可归因于持续输注琥珀酰胆碱的作用，肾VO₂升高的约三分之二可归因于肾功能增强。心脏VO₂的下降与心输出量增加和全身血管阻力降低有关。全身、骨骼肌和脑的代谢持续增加是显著的且无法用其他原因解释；这种情况在戊巴比妥麻醉3小时后出现，并持续至24小时。这可能是由于耐受性，表现为在稳定的深度麻醉期间，戊巴比妥血药水平不变但代谢增加，而不是对戊巴比妥的需求增加。
