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异氟烷会改变多巴胺的心血管作用吗?

Are the cardiovascular actions of dopamine altered by isoflurane?

作者信息

Raner C, Biber B, Henriksson B A, Lundberg J, Martner J, Winsö O

机构信息

Department of Anesthesiology, Ostra Hospital, Göteborg University, Gothenburg, Sweden.

出版信息

Acta Anaesthesiol Scand. 1995 Jul;39(5):678-84. doi: 10.1111/j.1399-6576.1995.tb04147.x.

Abstract

Dopamine seems theoretically to be a rationale choice when adrenergic support is needed to counter undesired cardiovascular depressant effects of isoflurane. Although the cardiovascular effects of isoflurane (ISO) and exogenous dopamine (DA) are well documented, there are no reports on their pharmacological interaction. The effects of ISO 1.4% (MAC 1.0) on the cardiovascular response to exogenous DA were studied in dogs during chloralose anesthesia. Instrumentation included catheterizations of the femoral artery (for aortic pressures and heart rate, HR), the pulmonary artery (for thermodilution cardiac output, CO, and pulmonary arterial pressures) and the left ventricle (for tip-manometer measured left ventricular end-diastolic pressure, LVEDP). ISO per se decreased HR (-16%), mean arterial pressure (MAP; -33%), CO (-29%), left ventricular dP/dt (LV dP/dt; -51%), and increased pulmonary artery occlusion (PAOP; +64%) and LVEDP (+28%). Prior to ISO, DA increased MAP, CO stroke volume (SV), LV dP/dt and LV dP/dt/SAP (systolic arterial pressure) at the dose 10 micrograms.kg-1.min-1. At the dose 20 micrograms.kg-1.min-1 DA, besides these effects, increased PAOP and mean pulmonary artery pressure (MPAP). During ISO, DA at the dose 10 micrograms.kg-1.min-1 restored MAP, CO, and SV to pre-ISO control levels, while LV dP/dt was increased to +96% above the pre-ISO control level. At the dose 20 micrograms.kg-1.min-1, DA increased MAP (+33%), LV dP/dt (+172%), PAOP (+132%) and MPAP (+50%) above pre-ISO control levels. The cardiac effects of DA were similar to when it was given alone.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

理论上,当需要肾上腺素能支持以对抗异氟烷不期望的心血管抑制作用时,多巴胺似乎是一个合理的选择。尽管异氟烷(ISO)和外源性多巴胺(DA)的心血管作用已有充分记录,但尚无关于它们药理相互作用的报道。在氯醛糖麻醉下,研究了1.4%(MAC 1.0)的ISO对犬对外源性DA心血管反应的影响。仪器设备包括股动脉插管(用于测量主动脉压和心率,HR)、肺动脉插管(用于热稀释法测量心输出量,CO,和肺动脉压)以及左心室插管(用于尖端压力计测量左心室舒张末期压力,LVEDP)。ISO本身可降低心率(-16%)、平均动脉压(MAP;-33%)、CO(-29%)、左心室dp/dt(LV dp/dt;-51%),并增加肺动脉闭塞压(PAOP;+64%)和LVEDP(+28%)。在给予ISO之前,剂量为10微克·千克-1·分钟-1的DA可增加MAP、CO、每搏输出量(SV)、LV dp/dt和LV dp/dt/SAP(收缩期动脉压)。剂量为20微克·千克-1·分钟-1的DA,除了这些作用外,还可增加PAOP和平均肺动脉压(MPAP)。在ISO期间,剂量为10微克·千克-1·分钟-1的DA可将MAP、CO和SV恢复到ISO前的对照水平,而LV dp/dt则增加到比ISO前对照水平高+96%。剂量为20微克·千克-1·分钟-1时,DA使MAP(+33%)、LV dp/dt(+172%)、PAOP(+132%)和MPAP(+50%)高于ISO前对照水平。DA的心脏作用与单独给药时相似。(摘要截断于250字)

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