Ide T, Kochi T, Isono S, Mizuguchi T
Department of Anesthesiology, Chiba University School of Medicine, Japan.
Acta Anaesthesiol Scand. 1993 Apr;37(3):253-7. doi: 10.1111/j.1399-6576.1993.tb03710.x.
The effect of isoflurane administration on diaphragmatic activity was investigated in six anaesthetized mechanically ventilated dogs. Diaphragmatic strength was assessed by measuring the transdiaphragmatic pressure (Pdi) generated during supramaximal stimulation of both cervical phrenic nerves at frequencies of 0.5, 10, 20, 50 and 100 Hz under partially isometric conditions at 1, 1.5 and 2 minimum alveolar anaesthetic concentrations (MAC), after maintaining 1 h of stable conditions. Pdi measurements were made at the start of the stimulation (initial) and at the end of a 2-s period (2-s). The force-frequency relationship was compared at each anaesthetic level. For single twitch (0.5 Hz) stimulation, the time constant of diaphragmatic relaxation was also assessed. The sequence of changing anaesthetic depth was altered in random fashion between animals. Pdi amplitude at single twitch stimulation was unchanged at the three anaesthetic concentrations. There was no significant difference in initial Pdi at various stimulus frequencies with increasing depth of isoflurane anaesthesia. In addition, no change in 2-s Pdi during low frequency stimulation (10 and 20 Hz) was noted during any of the three levels of anaesthesia. By contrast, 2-s Pdi with 50 Hz stimulation during 2 MAC isoflurane exposure decreased significantly below Pdi levels seen at 1 and 1.5 MAC (P < 0.01). Furthermore, 2-s Pdi at 100 Hz stimulation decreased significantly in a dose-dependent fashion. From these results, we conclude that isoflurane reduces diaphragmatic activity at higher stimulation frequencies of 50 and 100 Hz.
在六只麻醉状态下接受机械通气的犬中研究了异氟烷给药对膈活动的影响。在部分等长条件下,于1、1.5和2个最低肺泡麻醉浓度(MAC)时,在0.5、10、20、50和100Hz频率下对双侧颈膈神经进行超强刺激,测量产生的跨膈压(Pdi)来评估膈强度,在维持1小时稳定状态后进行测量。在刺激开始时(初始)和2秒时段结束时(2秒)进行Pdi测量。比较每个麻醉水平下的力-频率关系。对于单次抽搐(0.5Hz)刺激,还评估了膈松弛的时间常数。动物之间以随机方式改变麻醉深度的顺序。在三种麻醉浓度下,单次抽搐刺激时的Pdi幅度未发生变化。随着异氟烷麻醉深度增加,不同刺激频率下的初始Pdi无显著差异。此外,在三个麻醉水平中的任何一个水平下,低频刺激(10和20Hz)期间2秒Pdi均未观察到变化。相比之下,在2MAC异氟烷暴露期间,50Hz刺激时的2秒Pdi显著低于1MAC和1.5MAC时的Pdi水平(P<0.01)。此外,100Hz刺激时的2秒Pdi以剂量依赖方式显著降低。根据这些结果,我们得出结论,异氟烷在50和100Hz的较高刺激频率下会降低膈活动。