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丙泊酚对控制血压的中枢交感神经机制的作用。

Action of propofol on central sympathetic mechanisms controlling blood pressure.

作者信息

Krassioukov A V, Gelb A W, Weaver L C

机构信息

Department of Stroke and Aging, John P. Robarts Research Institute, University of Western Ontario.

出版信息

Can J Anaesth. 1993 Aug;40(8):761-9. doi: 10.1007/BF03009773.

DOI:10.1007/BF03009773
PMID:8403160
Abstract

This study was done using Wistar rats to determine if the actions of propofol (22 +/- 1, 40 +/- 2, 64 +/- 3 and 103 +/- 3 mg.kg-1 x hr-1) decreased blood pressure and heart rate through depression of brain stem vasomotor centres. All rats were given atropine to block vagal influences on the heart. Propofol decreased renal nerve activity as well as blood pressure and heart rate in a dose-dependent manner. Infusion of the lowest dose of propofol (22 +/- 1 mg.kg-1 x hr-1) had no effect on blood pressure, heart rate and renal nerve activity. Infusion of propofol at 40 +/- 2 mg.kg-1 x hr-1 decreased renal activity by 22 +/- 4% (mean +/- SEM) and at 64 +/- 3 mg.kg-1 x hr-1 it decreased renal nerve activity by 36 +/- 6%. Finally, infusion of the largest dose of propofol (102 +/- 3 mg.kg-1 x hr-1) decreased nerve activity by 50 +/- 5%. The haemodynamic changes observed in our experiments during the infusion propofol paralleled the changes in sympathetic firing, suggesting that hypotension was caused by central actions of propofol to depress sympathetic firing. In experiments with bolus injections of propofol, the renal nerve activity returned to normal before arterial pressure and heart rate recovered. Because decreases in blood pressure and heart rate were longer-lasting than changes in renal nerve activity, a part of the vasodepression and bradycardia caused by propofol likely resulted from direct actions on blood vessels and the heart. Sympathetic and cardiovascular responses to blocking neurons in the ventrolateral medulla with microinjection of glycine were depressed by propofol.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

本研究使用Wistar大鼠来确定丙泊酚(22±1、40±2、64±3和103±3毫克·千克⁻¹·小时⁻¹)的作用是否通过抑制脑干血管运动中枢而降低血压和心率。所有大鼠均给予阿托品以阻断迷走神经对心脏的影响。丙泊酚以剂量依赖性方式降低肾神经活动以及血压和心率。输注最低剂量的丙泊酚(22±1毫克·千克⁻¹·小时⁻¹)对血压、心率和肾神经活动无影响。输注40±2毫克·千克⁻¹·小时⁻¹的丙泊酚使肾活动降低22±4%(平均值±标准误),输注64±3毫克·千克⁻¹·小时⁻¹时使肾神经活动降低36±6%。最后,输注最大剂量的丙泊酚(102±3毫克·千克⁻¹·小时⁻¹)使神经活动降低50±5%。我们实验中在输注丙泊酚期间观察到的血流动力学变化与交感神经放电的变化平行,表明低血压是由丙泊酚抑制交感神经放电的中枢作用引起的。在丙泊酚推注实验中,肾神经活动在动脉压和心率恢复之前恢复正常。由于血压和心率的降低比肾神经活动的变化持续时间更长,丙泊酚引起的部分血管舒张和心动过缓可能是由于对血管和心脏的直接作用。用甘氨酸微量注射阻断延髓腹外侧神经元时,丙泊酚抑制了交感神经和心血管反应。(摘要截断于250字)

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本文引用的文献

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Is the Sympathetic System Detrimental in the Setting of Septic Shock, with Antihypertensive Agents as a Counterintuitive Approach? A Clinical Proposition.在感染性休克的情况下,交感神经系统是否有害,使用抗高血压药物作为一种有悖常理的方法是否可行?一项临床提议。
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Propofol Formulation Affects Myocardial Function in Newborn Infants.丙泊酚制剂对新生儿心肌功能的影响。
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Skin blood perfusion and cellular response to insertion of insulin pen needles with different diameters.不同直径胰岛素笔针头插入皮肤后的血液灌注及细胞反应
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Haemodynamic effects of a prolonged infusion of propofol as a supplement to nitrous oxide anaesthesia. Studies in association with peripheral arterial surgery.丙泊酚持续输注作为氧化亚氮麻醉补充剂的血流动力学效应。与外周动脉手术相关的研究。
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