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氟烷对通过躯体交感反射引发的升压和降压反应的影响:一种潜在的抗伤害感受作用。

The effects of halothane on pressor and depressor responses elicited via the somatosympathetic reflex: a potential antinociceptive action.

作者信息

Samso E, Farber N E, Kampine J P, Schmeling W T

机构信息

Department of Anesthesiology, Hospital del Mar, Autonomous University of Barcelona, Spain.

出版信息

Anesth Analg. 1994 Nov;79(5):971-9. doi: 10.1213/00000539-199411000-00026.

Abstract

The specific stimulation of various somatic sensory afferent nerves results in significant changes in autonomic responses, including systemic arterial pressure (AP) and heart rate (HR). These reflexively mediated responses have been termed the "somatosympathetic reflex" (SSR). The SSR is mediated at spinal and supraspinal sites within the central nervous system (CNS), and may, in part, represent a nociceptive response. The present investigation examined the actions of the volatile anesthetic, halothane, on the SSR evoked by electrical stimulation of peripheral nerves resulting in pressor or depressor alterations in AP and associated changes in HR. Experiments were completed in rats anesthetized with alpha-chloralose (50 mg/kg) and urethane (500 mg/kg) and mechanically ventilated. After nerve isolation, either the tibial nerve or the sciatic nerve was stimulated 1, 2, and 4 times the voltage threshold required to elicit a change in hemodynamics. Cardiovascular responses to nerve stimulation were recorded prior to, during, and after increasing concentrations of halothane (0.25%, 0.5%, and 1.0%). Halothane, as expected, produced dose-dependent decreases in AP and HR as compared to baseline controls. Electrical stimulation of the tibial nerve during control resulted in graded decreases in mean arterial pressure (MAP) with increasing current densities. Halothane significantly attenuated the depressor response to tibial nerve stimulation (decrease in MAP at maximal stimulation: 3 +/- 2 mm Hg with 1.0% halothane vs 21 +/- 2 mm Hg during control). Stimulation of the sciatic nerve resulted in current-dependent increases in AP which were significantly inhibited in the presence of halothane (increase in MAP at maximal stimulation: 7 +/- 3 mm Hg with 1.0% halothane vs 34 +/- 5 mm Hg during control).(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

各种躯体感觉传入神经的特定刺激会导致自主反应发生显著变化,包括体循环动脉压(AP)和心率(HR)。这些反射介导的反应被称为“躯体交感反射”(SSR)。SSR在中枢神经系统(CNS)的脊髓和脊髓上部位介导,并且可能部分代表伤害性反应。本研究检测了挥发性麻醉剂氟烷对由外周神经电刺激诱发的SSR的作用,该刺激会导致AP的升压或降压改变以及HR的相关变化。实验在使用α-氯醛糖(50mg/kg)和乌拉坦(500mg/kg)麻醉并机械通气的大鼠中完成。神经分离后,以引发血流动力学变化所需电压阈值的1、2和4倍刺激胫神经或坐骨神经。在增加氟烷浓度(0.25%、0.5%和1.0%)之前、期间和之后记录对神经刺激的心血管反应。与基线对照相比,氟烷如预期那样产生剂量依赖性的AP和HR降低。对照期间电刺激胫神经导致平均动脉压(MAP)随电流密度增加而分级降低。氟烷显著减弱了对胫神经刺激的降压反应(最大刺激时MAP的降低:1.0%氟烷时为3±2mmHg,对照期间为21±2mmHg)。刺激坐骨神经导致AP随电流增加,在氟烷存在时显著受到抑制(最大刺激时MAP的增加:1.0%氟烷时为7±3mmHg,对照期间为34±5mmHg)。(摘要截断于250字)

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