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异氟烷和氟烷对犬心室动脉耦联作用的差异。

The difference of isoflurane and halothane in ventriculoarterial coupling in dogs.

作者信息

Kawasaki T, Hoka S, Okamoto H, Okuyama T, Takahashi S

机构信息

Department of Anesthesiology and Critical Care Medicine, Faculty of Medicine, Kyushu University, Fukuoka, Japan.

出版信息

Anesth Analg. 1994 Oct;79(4):681-6. doi: 10.1213/00000539-199410000-00011.

Abstract

Effective arterial elastance (Ea) and left ventricular end-systolic elastance (Ees) are used as indices of cardiac afterload and cardiac contractility, respectively. We compared the effects of two volatile anesthetics, halothane and isoflurane, on ventriculoarterial coupling using an index of Ea/Ees in 20 mongrel dogs. Ees was obtained using a single-beat estimation technique. Ea was estimated as the ratio of the mean arterial pressure to stroke volume. Basal anesthesia consisted of pentobarbital and alpha-chloralose. Dogs were further anesthetized either with halothane 1 minimum alveolar anesthetic concentration (MAC) and 2 MAC (n = 10) or with isoflurane 1 MAC and 2 MAC (n = 10). Halothane 2 MAC significantly decreased the cardiac output, Ea, and Ees by 35.5% +/- 4.9%, 18.3% +/- 12.6%, and 39.7% +/- 10.8%, respectively. Isoflurane 2 MAC significantly decreased the cardiac output, Ea, and Ees by 37.9% +/- 4.0%, 38.7% +/- 6.4%, and 43.0% +/- 6.0%, respectively. The decreases in cardiac output and Ees were not significantly different between halothane and isoflurane. Halothane increased Ea/Ees from 0.83 +/- 0.05 to 1.22 +/- 0.13, whereas isoflurane maintained the Ees/Es at a constant level. Our results suggest that mechanical efficiency is well maintained during isoflurane anesthesia because it has an equivalent effect on left ventricular contractility and arterial properties, whereas halothane can impair mechanical efficiency by depressing left ventricular contractility more than the arterial system.

摘要

有效动脉弹性(Ea)和左心室收缩末期弹性(Ees)分别用作心脏后负荷和心脏收缩力的指标。我们使用Ea/Ees指数比较了两种挥发性麻醉剂氟烷和异氟烷对20只杂种犬心室动脉耦合的影响。Ees采用单搏估计技术获得。Ea估计为平均动脉压与每搏量之比。基础麻醉由戊巴比妥和α-氯醛糖组成。犬只再分别用1个最低肺泡有效浓度(MAC)和2个MAC的氟烷(n = 10)或1个MAC和2个MAC的异氟烷(n = 10)进一步麻醉。氟烷2个MAC使心输出量、Ea和Ees分别显著降低35.5%±4.9%、18.3%±12.6%和39.7%±10.8%。异氟烷2个MAC使心输出量、Ea和Ees分别显著降低37.9%±4.0%、38.7%±6.4%和43.0%±6.0%。氟烷和异氟烷在心输出量和Ees降低方面无显著差异。氟烷使Ea/Ees从0.83±0.05增加到1.22±0.13,而异氟烷使Ea/Ees维持在恒定水平。我们的结果表明,异氟烷麻醉期间机械效率得到良好维持,因为它对左心室收缩力和动脉特性有同等影响,而氟烷可能通过比动脉系统更显著地抑制左心室收缩力来损害机械效率。

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