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异氟烷诱导的内脏交感神经切除术。

Isoflurane-induced splanchnic sympathectomy.

作者信息

Jordan D, Miller E D

机构信息

Department of Anesthesiology, Columbia University, College of Physicians and Surgeons, New York, New York 10032.

出版信息

Anesth Analg. 1993 Aug;77(2):291-6. doi: 10.1213/00000539-199308000-00013.

DOI:10.1213/00000539-199308000-00013
PMID:8346827
Abstract

To ascertain whether isoflurane produces a peripheral splanchnic sympathectomy as compared to fentanyl or pentobarbital anesthesia, 12 mongrel dogs (30-45 kg) were allocated randomly to one of three anesthetic test groups, tracheally intubated, surgically prepared, and subjected to unilateral electrical stimulation of the greater splanchnic nerve. Anesthetically, Group 1 animals (n = 4) received pentobarbital, Group 2 animals (n = 4) were administered fentanyl, and Group 3 animals (n = 4) received isoflurane. Stimulation continued for 90 min. Each second of stimulation consisted of 20 stimuli of 0.5 minimum alveolar anesthetic concentration duration and 5 V intensity, delivered during a 0.2-s interval, followed by an 0.8-s pause. To assess splanchnic sympathetic responses, mean arterial blood pressure, heart rate, pulmonary artery diastolic, cardiac output, adrenal blood flow, adrenal and arterial norepinephrine (N) and epinephrine (E) were obtained before and at 5, 10, 15, 30, 45, 60, and 90 min during stimulation. In Group 1 animals (pentobarbital), electrical stimulation elicited marked increases in mean arterial blood pressure, pulmonary artery diastolic, and cardiac output (P < 0.001). Examination of the adrenal effluent, which was exteriorized from the animal during the protocol, revealed that adrenal blood flow, adrenal vein N and E concentrations dramatically increased (P < 0.0001). Arterial N and E concentrations remained unchanged. Results of Group 2 animals (fentanyl) were similar to those of Group 1; mean arterial blood pressure, pulmonary artery diastolic, and cardiac output increased (P < 0.005). Adrenal blood flow, adrenal vein N and E increased dramatically (P < 0.0001).(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

为确定异氟烷与芬太尼或戊巴比妥麻醉相比是否会导致外周内脏交感神经切除术,将12只杂种犬(30 - 45千克)随机分配到三个麻醉测试组之一,进行气管插管、手术准备,并接受内脏大神经的单侧电刺激。麻醉方面,第1组动物(n = 4)接受戊巴比妥,第2组动物(n = 4)给予芬太尼,第3组动物(n = 4)接受异氟烷。刺激持续90分钟。每次刺激的每一秒包括20次刺激,刺激浓度为0.5最低肺泡麻醉浓度持续时间,强度为5伏,在0.2秒间隔内给予,随后是0.8秒的暂停。为评估内脏交感神经反应,在刺激前以及刺激期间的5、10、15、30、45、60和90分钟时获取平均动脉血压、心率、肺动脉舒张压、心输出量、肾上腺血流量、肾上腺及动脉去甲肾上腺素(N)和肾上腺素(E)。在第1组动物(戊巴比妥)中,电刺激引起平均动脉血压、肺动脉舒张压和心输出量显著增加(P < 0.001)。在实验过程中从动物体内引出的肾上腺流出液检查显示,肾上腺血流量、肾上腺静脉N和E浓度显著增加(P < 0.0001)。动脉N和E浓度保持不变。第2组动物(芬太尼)的结果与第1组相似;平均动脉血压、肺动脉舒张压和心输出量增加(P < 0.005)。肾上腺血流量、肾上腺静脉N和E显著增加(P < 0.0001)。(摘要截短至250字)

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