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[氟烷或硝酸甘油控制性降压麻醉对冠状动脉血流的影响——正常组与等容血液稀释组的比较]

[Influence of the hypotensive anesthesia using halothane or trinitroglycerin on coronary blood flow--comparison of normal group and normovolemic hemodilution group].

作者信息

Kobori M, Negishi H, Hosoyamada A

机构信息

Department of Anesthesiology, School of Medicine, Showa University, Tokyo.

出版信息

Masui. 1995 Jul;44(7):963-70.

PMID:7543620
Abstract

We divided adult mongrel dogs under halothane anesthesia (1 MAC: 0.86%) into the normal group (N-group: no-hemodilution, with Hct 38 +/- 7%) and the hemodilutional group (H-group: normovolemic hemodilution, with Hct 38 +/- 4%-->21 +/- 4%). For dilution of blood, Dextran 70 was used. In both groups, control values of respiratory and circulatory parameters and coronary blood flow (CBF) were measured. We repeated these measurements after animals had been anesthetized by two different methods:halothane hypotensive anesthesia and trinitroglycerine hypotensive anesthesia. Under hypotensive anesthesia with halothane, CI, LV dp/dt max, and LVSWI decreased significantly as compared to control values in both group. CBF also decreased significantly as compared to the control values in both groups. Under trinitroglycerine hypotensive anesthesia, CI, LV dp/dt max and LVSWI decreased significantly from the control values in both groups as observed under halothane hypotensive anesthesia. Differing from these findings, under trinitroglycerine hypotensive anesthesia no difference from the control group was observed in CBF in N-group, while in H-group CBF decreased significantly from the control value. It was indicated from our results that the increase in coronary blood flow induced by trinitroglycerine becomes obscure under hemodilutional state.

摘要

我们将处于氟烷麻醉(1MAC:0.86%)下的成年杂种犬分为正常组(N组:不进行血液稀释,血细胞比容为38±7%)和血液稀释组(H组:等容血液稀释,血细胞比容从38±4%降至21±4%)。使用右旋糖酐70进行血液稀释。在两组中,测量呼吸、循环参数及冠状动脉血流量(CBF)的对照值。在动物通过两种不同方法麻醉后重复这些测量:氟烷降压麻醉和三硝酸甘油降压麻醉。在氟烷降压麻醉下,与两组的对照值相比,心脏指数(CI)、左心室dp/dt最大值及左心室每搏功指数(LVSWI)均显著降低。与两组的对照值相比,冠状动脉血流量也显著降低。在三硝酸甘油降压麻醉下,如在氟烷降压麻醉下所观察到的,两组的CI、LV dp/dt max和LVSWI均较对照值显著降低。与这些结果不同的是,在三硝酸甘油降压麻醉下,N组的冠状动脉血流量与对照组相比无差异,而在H组中,冠状动脉血流量较对照值显著降低。我们的结果表明,在血液稀释状态下,三硝酸甘油诱导的冠状动脉血流量增加变得不明显。

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