Preckel M P, Dégoute C S, Dubreuil C, Boulud B, Tassard A M, Banssillon V
C.H.U. Lyon-Sud, Services d'Anesthésie-réanimation, Pierre-Bénite, France.
Rev Laryngol Otol Rhinol (Bord). 1995;116(1):69-72.
The aim of this study was to assess the effects on cochlear blood flow measured by laser-Doppler of two vasoactive agents known for their supposed effectiveness in the presbyacousy treatment (buflomedil, naftidrofuryl), 16 patients undergoing acoustic neurinoma surgery were studied. Cochlear blood flow (CBF) was continuously recorded after the head of the probe was inserted into the internal ear through the round window. Systolic arterial pressure (SAP) and heart rate (HR) were continuously recorded via an arterial cannula. Hemodynamic variations due to buflomedil (400 mg in bolus) and to naftidrofuryl (200 mg in bolus) were compared with those of sodium nitroprusside (500 micrograms in bolus) in each case with anova. Buflomedil did not alter CBF (0%), SAP (+0.14 +/- 1.7%), HR (+3.4 +/- 3.4%). Naftidrofuryl provoked a significant decrease (P < 0.05) of CBF (-14.5 +/- 7.55%), SAP (-13.7 +/- 4%), and a significant increase (P < 0.05) of HR (+8.5 +/- 3.5%); there is a relationship between CBF and SAP (r = 0.88 P < 0.05). NPS provoked a significant decrease (P < 0.01) of CBF (-34.7 +/- 7.7%) SAP (-26.8 +/- 5.4%) and a significant increase (P < 0.01) of HR(+14.7 +/- 7.3%) in the same way of naftidrofuryl (P < 0.01). In conclusion, human cochlear microcirculation depends upon pharmacological hemodynamic variations such as animal models or middle ear microcirculation. If buflomedil did not alter it, naftidrofuryl provoked a reduction by a direct vasodilator effect inducing hypotension like sodium nitroprusside.
本研究旨在评估两种以在老年性耳聋治疗中假定的有效性而闻名的血管活性药物(丁咯地尔、萘呋胺酯)对通过激光多普勒测量的耳蜗血流的影响,对16例接受听神经瘤手术的患者进行了研究。在将探头头部通过圆窗插入内耳后,连续记录耳蜗血流(CBF)。通过动脉插管连续记录收缩动脉压(SAP)和心率(HR)。在每种情况下,使用方差分析将丁咯地尔(400mg推注)和萘呋胺酯(200mg推注)引起的血流动力学变化与硝普钠(500微克推注)的变化进行比较。丁咯地尔未改变CBF(0%)、SAP(+0.14±1.7%)、HR(+3.4±3.4%)。萘呋胺酯引起CBF显著降低(P<0.05)(-14.5±7.55%)、SAP显著降低(-13.7±4%),以及HR显著升高(P<0.05)(+8.5±3.5%);CBF与SAP之间存在相关性(r = 0.88,P<0.05)。硝普钠引起CBF显著降低(P<0.01)(-34.7±7.7%)、SAP显著降低(-26.8±5.4%),以及HR显著升高(P<0.01)(+14.7±7.3%),与萘呋胺酯的情况相同(P<0.01)。总之,人类耳蜗微循环取决于药理学血流动力学变化,如动物模型或中耳微循环。如果丁咯地尔未改变它,萘呋胺酯会通过直接血管舒张作用导致降低,诱发与硝普钠类似的低血压。