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出血性休克期间麻醉剂对内脏动脉血流的不同影响。

Differing effects of anesthetics on splanchnic arterial blood flow during hemorrhagic shock.

作者信息

Myers S I, Hernandez R, Miller T A

机构信息

Department of Surgery, University of Texas Southwestern Medical School at Dallas.

出版信息

J Appl Physiol (1985). 1994 Jun;76(6):2304-9. doi: 10.1152/jappl.1994.76.6.2304.

Abstract

The effect of anesthesia on splanchnic blood flow was examined during hemorrhagic shock and resuscitation. Sprague-Dawley rats were anesthetized with the inhalation anesthetic, methoxyflurane, or pentobarbital (65 mg/kg). Transonic Doppler flow probes were placed around the superior mesenteric artery (SMA) and the abdominal aorta, and the animals were subjected to acute hemorrhage (or sham) to 30 mmHg for 90 min followed by 30 min of resuscitation with shed blood (n = 6/group). At 90, 105, and 120 min, sham animals in both anesthetic groups showed comparable blood pressures with a 50% decrease in SMA and aortic blood flow. Acute hemorrhage decreased SMA blood flow by 94.5 +/- 0.01 and 86.0 +/- 2.8%, respectively, in the pentobarbital and methoxyflurane groups, with similar changes occurring in aortic blood flow. During resuscitation, arterial pressure remained significantly depressed and SMA blood flow decreased by 65% in the pentobarbital group, whereas blood pressure returned to control levels and SMA blood flow increased to 56% of control values (P < 0.001) in the methoxyflurane group. The findings indicate that the choice of anesthetic agent may significantly impact splanchnic blood flow and needs to be taken into account when designing experiments examining effects of hemorrhagic shock.

摘要

在失血性休克和复苏过程中,研究了麻醉对内脏血流的影响。将Sprague-Dawley大鼠用吸入麻醉剂甲氧氟烷或戊巴比妥(65mg/kg)麻醉。将跨音速多普勒血流探头置于肠系膜上动脉(SMA)和腹主动脉周围,动物接受急性出血(或假手术)至30mmHg并持续90分钟,随后用自体血复苏30分钟(每组n = 6)。在90、105和120分钟时,两个麻醉组的假手术动物血压相当,SMA和主动脉血流减少50%。急性出血使戊巴比妥组和甲氧氟烷组的SMA血流分别减少94.5±0.01%和86.0±2.8%,主动脉血流也有类似变化。在复苏过程中,戊巴比妥组动脉压仍显著降低,SMA血流减少65%,而甲氧氟烷组血压恢复到对照水平,SMA血流增加到对照值的56%(P < 0.001)。这些发现表明,麻醉剂的选择可能会显著影响内脏血流,在设计研究失血性休克影响的实验时需要考虑这一点。

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