Schaps D K
Fortschr Med. 1982 Aug 12;100(30):1404-6.
In 31 patients with congenital heart disease effects of 5 mg/kg thiopental or 1 mg/kg methohexital on hemodynamics, inotropic state, myocardial metabolism and myocardial oxygen consumption were investigated after cardiac surgery (basic neuroleptanalgesia). In comparison to a control group both barbiturates caused a decrease in stroke volume and arterial pressure. This, however, was mainly attributable to venous pooling and not to a negative inotropic effect. In accordance with the changes in hemodynamics there was a remarkable decrease in myocardial oxygen consumption (5 mg/kg thiopental: Eg--17,7%; 1 mg/kg methohexital: Eg--11,7%). It could be demonstrated that arterial and coronarvenous lactate correlated directly with plasma concentrations of barbiturates. Furthermore it may be possible that the slight increase in free fatty can have deleterious effects on myocardial glucose metabolism. No significant alterations in serum electrolytes concentrations were observed. Plasma concentrations of thiopental and methohexital were determined by specific gaschromatography. In spite of the great interindividual variation of plasma barbiturate concentration there was an equilibrium between arterial and coronarvenous barbiturate levels within two minutes.
在31例先天性心脏病患者心脏手术后（基础神经安定镇痛），研究了5mg/kg硫喷妥钠或1mg/kg美索比妥对血流动力学、心肌收缩状态、心肌代谢及心肌氧耗的影响。与对照组相比，两种巴比妥类药物均导致每搏量和动脉压下降。然而，这主要归因于静脉淤血，而非负性肌力作用。与血流动力学变化一致，心肌氧耗显著降低（5mg/kg硫喷妥钠：Eg降低17.7%；1mg/kg美索比妥：Eg降低11.7%）。可以证明，动脉血和冠状静脉血乳酸与巴比妥类药物血浆浓度直接相关。此外，游离脂肪酸的轻微升高可能对心肌葡萄糖代谢产生有害影响。未观察到血清电解质浓度有显著变化。硫喷妥钠和美索比妥的血浆浓度通过特定气相色谱法测定。尽管血浆巴比妥类药物浓度个体差异很大，但在两分钟内动脉血和冠状静脉血巴比妥类药物水平达到平衡。
