McPherson R W, Kirsch J R, Moore L E, Traystman R J
Department of Anesthesiology/Critical Care Medicine, Johns Hopkins Medical Institutions, Baltimore, Maryland.
Anesth Analg. 1993 Nov;77(5):891-7. doi: 10.1213/00000539-199311000-00004.
The mechanism by which halothane, isoflurane, and nitrous oxide increase cerebral blood flow (CBF) is unknown. We assessed the cerebrovascular effects of nitrous oxide (70%; n = 6), isoflurane (1 minimum alveolar anesthetic concentration: 1.4%; n = 6) or halothane (1 minimum alveolar anesthetic concentration: 0.8%; n = 6) before and after blockade of nitric oxide (NO) synthase with 40 mg/kg N omega-nitro-L-arginine methyl ester (L-NAME) intravenously in dogs with baseline pentobarbital anesthesia. Baseline CBF (microspheres) was determined after 1 h of pentobarbital anesthesia. Cerebral perfusion pressure (CPP) was maintained during inhaled anesthetic or L-NAME by either hemorrhage or inflation of an intra-aortic balloon. Before L-NAME, halothane and isoflurane increased CBF (40 +/- 4 to 56 +/- 6 mL.min-1 x 100 g-1 and 43 +/- 6 to 78 +/- 12 mL.min-1 x 100 g-1, respectively) with no change in cerebral oxygen consumption (baseline: halothane, 2.6 +/- 0.2; isoflurane, 2.0 +/- 0.2 mL.min-1 x 100 g-1). On the contrary, nitrous oxide increased CBF similarly (40 +/- 6 to 57 +/- 8 mL.min-1 x 100 g-1), but increased cerebral oxygen consumption (2.2 +/- 0.3 to 3.0 +/- 0.3 mL.min-1 x 100 g-1). L-NAME decreased blood flow in the neurohypophysis by 80% with no change in blood flow in other brain regions. After L-NAME, reexposure to nitrous oxide, halothane, or isoflurane resulted in no change in CBF.(ABSTRACT TRUNCATED AT 250 WORDS)
氟烷、异氟烷和氧化亚氮增加脑血流量(CBF)的机制尚不清楚。我们评估了在基线戊巴比妥麻醉的犬中,静脉注射40mg/kg Nω-硝基-L-精氨酸甲酯(L-NAME)阻断一氧化氮(NO)合酶前后,氧化亚氮(70%;n = 6)、异氟烷(1最低肺泡麻醉浓度:1.4%;n = 6)或氟烷(1最低肺泡麻醉浓度:0.8%;n = 6)对脑血管的影响。在戊巴比妥麻醉1小时后测定基线CBF(微球法)。通过出血或主动脉内球囊充气在吸入麻醉剂或L-NAME期间维持脑灌注压(CPP)。在L-NAME之前,氟烷和异氟烷增加CBF(分别从40±4增加到56±6 mL·min-1×100 g-1和从43±6增加到78±12 mL·min-1×100 g-1),而脑氧耗无变化(基线:氟烷,2.6±0.2;异氟烷,2.0±0.2 mL·min-1×100 g-1)。相反,氧化亚氮同样增加CBF(从40±6增加到57±8 mL·min-1×100 g-1),但增加了脑氧耗(从2.2±0.3增加到3.0±0.3 mL·min-1×100 g-1)。L-NAME使神经垂体血流量减少80%,而其他脑区血流量无变化。L-NAME后,再次暴露于氧化亚氮、氟烷或异氟烷导致CBF无变化。(摘要截断于250字)