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机械通气过度:对用戊巴比妥或戊巴比妥-氟烷麻醉的犬的特殊房室传导、室上性不应期及实验性房性心律失常的影响

Mechanical hyperventilation: effect on specialized atrioventricular conduction, supraventricular refractoriness, and experimental atrial arrhythmias in dogs anesthetized with pentobarbital or pentobarbital-halothane.

作者信息

Ammendrup P, Atlee J L

出版信息

Anesth Analg. 1980 Nov;59(11):839-46.

PMID:7191673
Abstract

The effect of hypocapnia (PCO2ET 25 vs 40 torr) on specialized atrioventricular (AV) conduction, supraventricular refractory periods, and experimental atrial arrhythmias provoked by premature atrial stimulation (atrial echoes-echoes, repetitive atrial firing (RAF)) was assessed in dogs anesthetized with pentobarbital or pentobarbital-halothane (1.0% end-tidal). Catheter His bundle electrocardiography was used. Both hypocapnia and halothane prolonged AV nodal conduction, but the effect of halothane was more pronounced. Halothane prolonged the atrial functional (AtFRP), atrial effective (AtERP), and AV nodal functional refractory (AVFRP) periods. These effects of halothane were linked to an increased incidence of RAF but not to echoes. Hypocapnia prolonged the AVFRP (less than halothane), had no effect on the AtFRP and shortened the AtERP. These effects of hypocapnia were associated with an increased incidence of echoes, but not with RAF. Echoes and RAF are thought to be caused by reentry within the sinus node, atria, and AV node. The differing effects of halothane and hypocapnia on the incidence of these arrhythmias may be due to differning effects on supraventricular refractoriness.

摘要

在戊巴比妥或戊巴比妥 - 氟烷(呼气末浓度1.0%)麻醉的犬中,评估低碳酸血症(呼气末二氧化碳分压25与40托)对特殊房室(AV)传导、室上性不应期以及由房性早搏刺激诱发的实验性房性心律失常(房性回波 - 回波、重复性房性激动(RAF))的影响。采用导管希氏束心电图检查。低碳酸血症和氟烷均延长房室结传导,但氟烷的作用更显著。氟烷延长心房功能不应期(AtFRP)、心房有效不应期(AtERP)和房室结功能不应期(AVFRP)。氟烷的这些作用与RAF发生率增加有关,但与回波无关。低碳酸血症延长AVFRP(程度小于氟烷),对AtFRP无影响并缩短AtERP。低碳酸血症的这些作用与回波发生率增加有关,但与RAF无关。回波和RAF被认为是由窦房结、心房和房室结内的折返引起的。氟烷和低碳酸血症对这些心律失常发生率的不同影响可能是由于对室上性不应性的不同作用。

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