Goertz A W, Schmidt M, Seefelder C, Lindner K H, Georgieff M
Department of Anesthesiology, University of Ulm Medical Center, Federal Republic of Germany.
Anesth Analg. 1993 Aug;77(2):227-31. doi: 10.1213/00000539-199308000-00004.
By using transesophageal echocardiography, we examined the effect of phenylephrine (PHE) bolus administration on left ventricular function in 16 patients with no known cardiovascular disease during isoflurane-induced hypotension. PHE was compared with norepinephrine (NE). The patients received an intravenous bolus of PHE (2 micrograms/kg) or NE (0.1 microgram/kg) in random order. The second substance was administered after levels of arterial blood pressure and heart rate returned to baseline levels. We determined fractional area change, end-systolic wall stress, and rate-corrected mean velocity of circumferential fiber shortening. Both substances effectively restored arterial blood pressure. However, after PHE, fractional area change decreased from 0.45 to 0.31 (mean) and rate corrected mean velocity of circumferential fiber shortening from 0.88 to 0.57 circumference/s, whereas both variables remained unchanged in response to NE. End-systolic wall stress increased after PHE and NE from 47.4 to 91.2 and from 54.0 to 65.2 10(3) dyne/cm2, respectively. We conclude that phenylephrine, given as intravenous bolus to patients under isoflurane hypotension, causes a transient impairment of left ventricular systolic performance.
通过经食管超声心动图，我们检查了在异氟烷诱导的低血压期间，16例无已知心血管疾病患者静脉推注去氧肾上腺素（PHE）对左心室功能的影响。将PHE与去甲肾上腺素（NE）进行比较。患者随机顺序接受静脉推注PHE（2微克/千克）或NE（0.1微克/千克）。在动脉血压和心率恢复到基线水平后给予第二种药物。我们测定了面积变化分数、收缩末期壁应力和圆周纤维缩短的速率校正平均速度。两种药物均有效恢复了动脉血压。然而，给予PHE后，面积变化分数从0.45降至0.31（平均值），圆周纤维缩短的速率校正平均速度从0.88降至0.57周长/秒，而给予NE后这两个变量均保持不变。给予PHE和NE后，收缩末期壁应力分别从47.4增加到91.2和从54.0增加到65.2 10（3）达因/平方厘米。我们得出结论，在异氟烷低血压状态下给患者静脉推注去氧肾上腺素会导致左心室收缩功能短暂受损。
