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戊巴比妥对离体犬左心室肌力状态的影响。

Effects of pentobarbital on inotropic state of isolated canine left ventricle.

作者信息

Snyder D S, Harasawa Y, Sagawa K, Hunter W C

机构信息

Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21205.

出版信息

Heart Vessels. 1993;8(3):128-35. doi: 10.1007/BF01744797.

Abstract

Although pentobarbital has been found to depress myocardial function, the magnitude of its direct effects on ventricular contraction at anesthetic concentrations has not been well quantified. The direct effects of pentobarbital on left ventricular function were measured by employing an isolated canine heart preparation with a blood oxygenator. Seven hearts were perfused with blood, dextran, and perfluorochemical artificial blood. Ventricular function was evaluated using the slope of the end-systolic pressure-volume relationship (Ees) and the maximal rate of pressure development (dP/dtmax) in ventricles contracting isovolumically in control, after a low dose (13 micrograms/ml), and after a high dose (48 micrograms/ml) of pentobarbital. These concentrations represent one-half and two times the typical value (25 micrograms/ml) found to produce anesthesia in canines (assessed by tail clamp or blink reflex). The low dose of pentobarbital did not produce clear-cut depression in contractile function. The high dose of pentobarbital produced significant reductions of Ees, and dP/dtmax: Ees decreased 29%, from a control of 4.30 +/- 0.84 to 3.05 +/- 0.49 mmHg/ml and dP/dtmax decreased 24%, from a control of 909 +/- 148 to 695 +/- 173 mmHg/s. Thus, the threshold for the direct depressant effect of pentobarbital on ventricular function falls within the range of half to double the typically-reported anesthetic concentrations.

摘要

虽然已发现戊巴比妥会抑制心肌功能,但在麻醉浓度下其对心室收缩的直接作用程度尚未得到很好的量化。戊巴比妥对左心室功能的直接作用通过使用带有血液氧合器的离体犬心制备来测量。用血液、右旋糖酐和全氟化学人工血液灌注七颗心脏。在对照、低剂量(13微克/毫升)和高剂量(48微克/毫升)戊巴比妥给药后,使用等容收缩心室的收缩末期压力-容积关系(Ees)斜率和最大压力上升速率(dP/dtmax)来评估心室功能。这些浓度分别代表在犬类中产生麻醉作用的典型值(25微克/毫升)的一半和两倍(通过尾夹或眨眼反射评估)。低剂量的戊巴比妥未对收缩功能产生明显抑制。高剂量的戊巴比妥使Ees和dP/dtmax显著降低:Ees从对照值4.30±0.84降低29%至3.05±0.49毫米汞柱/毫升,dP/dtmax从对照值909±148降低24%至695±173毫米汞柱/秒。因此,戊巴比妥对心室功能直接抑制作用的阈值落在通常报告的麻醉浓度的一半至两倍范围内。

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