Yamaguchi H, Harukuni I, Naito H
Department of Anesthesiology, University of Tsukuba, Ibaraki, Japan.
Can J Anaesth. 1995 May;42(5 Pt 1):425-33. doi: 10.1007/BF03015491.
Deliberate hypotension decreases blood loss and transfusion but it may be accompanied by adverse effects due either to the hypotensive agents themselves or to haemodynamic alterations. Prostaglandin E1 (PGE1) has the advantage of a diuretic effect coupled with systemic hypotension. To elucidate the mechanisms by which PGE1 induces diuresis we compared the haemodynamic, diuretic and hormonal responses to PGE1 infusion simultaneously with epidural lidocaine (EP-L n = 7), epidural fentanyl (EP-F n = 8) or epidural saline (CONT n = 7) in halothane anaesthetized mongrel dogs. All groups developed a decrease in mean arterial pressure during PGE1 infusion (from 105 +/- 24 to 77 +/- 18 mmHg in EP-L; 106 +/- 19 to 79 +/- 13 mmHg in the EP-F; and 129 +/- 14 to 106 +/- 18 mmHg in the CONT groups (mean +/- SD)) (P < 0.05). In the EP-F and CONT groups urinary output increased during PGE1 infusion (from 4.31 +/- 1.89 to 6.15 +/- 2.03 ml.min-1 and 2.71 +/- 1.23 to 4.48 +/- 1.66 ml.min-1 (P < 0.05), respectively) and was accompanied by increases in renal blood flow (from 87.0 +/- 40.7 to 111.0 +/- 42.8 ml.min-1 and from 121.6 +/- 46.6 to 158.4 +/- 64.9 ml.min-1 (P < 0.05), respectively) and in fractional excretion of sodium (FENa) (from 4.78 +/- 3.88 to 7.63 +/- 5.20% in CONT group).(ABSTRACT TRUNCATED AT 250 WORDS)
控制性低血压可减少失血和输血,但可能因降压药物本身或血流动力学改变而伴有不良反应。前列腺素E1(PGE1)具有利尿作用并伴有全身低血压的优点。为阐明PGE1诱导利尿的机制,我们在氟烷麻醉的杂种犬中,将PGE1输注时的血流动力学、利尿和激素反应与硬膜外利多卡因(EP-L,n = 7)、硬膜外芬太尼(EP-F,n = 8)或硬膜外生理盐水(对照组,n = 7)同时进行了比较。所有组在PGE1输注期间平均动脉压均下降(EP-L组从105±24降至77±18 mmHg;EP-F组从106±19降至79±13 mmHg;对照组从129±14降至106±18 mmHg(平均值±标准差))(P < 0.05)。在EP-F组和对照组中,PGE1输注期间尿量增加(分别从4.31±1.89增至6.15±2.03 ml·min-1和从2.71±1.23增至4.48±1.66 ml·min-1(P < 0.05)),并伴有肾血流量增加(分别从87.0±40.7增至111.0±42.8 ml·min-1和从121.6±46.6增至158.4±64.9 ml·min-1(P < 0.05))以及钠分数排泄(FENa)增加(对照组从4.78±3.88增至7.63±5.20%)。(摘要截断于250字)