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尼莫地平不影响麻醉猪的脑自动调节反应。

Nimodipine does not affect the cerebral autoregulatory response in the anesthetized pig.

作者信息

Stånge K, Lagerkranser M, Sollevi A

机构信息

Department of Anaesthesiology and Intensive Care, Karolinska Hospital, Stockholm, Sweden.

出版信息

J Neurosurg Anesthesiol. 1994 Apr;6(2):116-21. doi: 10.1097/00008506-199404000-00007.

Abstract

The effect of the calcium blocker nimodipine on the cerebral blood flow (CBF) and cerebral autoregulatory responses was examined in seven fentanyl/N2O/anesthetized pigs. CBF was measured continuously from the sagittal sinus by a venous outlet flow technique. Cerebral autoregulation tests were performed before, after 30 min of nimodipine infusion (0.5 microgram.kg-1.min-1), and at 30 min after the infusion. The autoregulatory response to a gradual blood pressure increase was tested by infusion of angiotensin, and to a gradual blood pressure decrease was tested by caval block. The slope of the relationship between the regional cerebral vascular resistance (rCVR) and mean arterial blood pressure (MABP) was used as a measure of the autoregulatory capacity. The lower limit of autoregulation was determined as the MABP at which rCVR did not further decrease. An i.v. bolus dose (10 micrograms.kg-1) of nimodipine resulted in a transient increase in rCBF during 3 min, together with an MABP reduction. After 1 h of nimodipine infusion, MABP was reduced (19%), while rCBF, rCVR, and cerebral metabolism were unaffected. In the control condition, a preserved cerebral autoregulatory response to the increase of MABP (+30 mm Hg) was indicated by an unaffected rCBF and determined by the slope of the rCVR/MABP regression line (0.053), not different from the slope during blood pressure decrease (0.063). The cerebral autoregulatory responses to increase or decrease in MABP were not attenuated by nimodipine infusion. The lower limit of autoregulation (48 +/- 6 mm Hg) was not altered by nimodipine.

摘要

在7只接受芬太尼/氧化亚氮麻醉的猪身上,研究了钙通道阻滞剂尼莫地平对脑血流量(CBF)和脑自动调节反应的影响。采用静脉流出技术,从矢状窦连续测量CBF。在尼莫地平输注(0.5微克·千克⁻¹·分钟⁻¹)30分钟前、输注后30分钟以及输注后30分钟时进行脑自动调节测试。通过输注血管紧张素测试对血压逐渐升高的自动调节反应,通过腔静脉阻断测试对血压逐渐降低的自动调节反应。局部脑血管阻力(rCVR)与平均动脉血压(MABP)之间关系的斜率用作自动调节能力的指标。自动调节下限被确定为rCVR不再进一步降低时的MABP。静脉推注剂量(10微克·千克⁻¹)的尼莫地平在3分钟内导致rCBF短暂增加,同时MABP降低。尼莫地平输注1小时后,MABP降低(19%),而rCBF、rCVR和脑代谢未受影响。在对照条件下,rCBF未受影响表明对MABP升高(+30毫米汞柱)存在保留的脑自动调节反应,并且由rCVR/MABP回归线的斜率(0.053)确定,与血压降低期间的斜率(0.063)无差异。尼莫地平输注未减弱对MABP升高或降低的脑自动调节反应。尼莫地平未改变自动调节下限(48±6毫米汞柱)。

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