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氯胺酮对有或无来自外周感受器传入输入的(已切断迷走神经的)家兔肾交感神经活动和膈神经活动的影响。

The effects of ketamine on renal sympathetic nerve activity and phrenic nerve activity in rabbits (with vagotomy) with and without afferent inputs from peripheral receptors.

作者信息

Sasao J, Taneyama C, Kohno N, Goto H

机构信息

Department of Anesthesiology, University of Kansas Medical Center, Kansas City 66160-747, USA.

出版信息

Anesth Analg. 1996 Feb;82(2):362-7. doi: 10.1097/00000539-199602000-00026.

Abstract

One reason for the reported conflicting results of the effect of ketamine on hemodynamics and respiration may be variations in afferent inputs from peripheral receptors to the central nervous system. In order to evaluate unmasked direct effects of ketamine on sympathetic nerve and phrenic nerve outflow, totally deafferented (involving vagus, sinus nerve, aortic depressor nerve) rabbits (n = 18), rabbits with vagotomy (n = 21), and neuraxis-intact rabbits (n = 6) were used in this study. The animals were anesthetized with urethane and mechanically ventilated. Ketamine 0.5, 1, or 2 mg/kg was injected intravenously and mean arterial pressure (MAP), heart rate (HR), and integrated renal sympathetic nerve and phrenic nerve activity (IRSNA, IPNA) were recorded before, and 1, 2, 3, 5, and 10 min after injection. MAP and IRSNA were significantly decreased, even by the smallest dose of ketamine, in the totally deafferented group. IPNA was decreased by the largest dose of ketamine only in the totally deafferented group. On the other hand, spontaneous respiratory frequency was decreased in the totally deafferented and vagotomy groups, but more so in the totally deafferented group. In the neuraxis-intact group, the only significant change with the largest dose of ketamine, 2 mg/kg was a slight increase in HR. We conclude that ketamine can suppress vasomotor and respiratory centers directly, and that the suppression is counterbalanced by afferent inputs from peripheral receptors.

摘要

氯胺酮对血流动力学和呼吸作用的影响报告结果相互矛盾的一个原因可能是从外周感受器到中枢神经系统的传入输入存在差异。为了评估氯胺酮对交感神经和膈神经传出的未被掩盖的直接作用,本研究使用了完全去传入神经(包括迷走神经、窦神经、主动脉减压神经)的家兔(n = 18)、迷走神经切断的家兔(n = 21)和神经轴完整的家兔(n = 6)。动物用乌拉坦麻醉并进行机械通气。静脉注射0.5、1或2 mg/kg氯胺酮,在注射前以及注射后1、2、3、5和10分钟记录平均动脉压(MAP)、心率(HR)以及肾交感神经和膈神经活动积分(IRSNA、IPNA)。在完全去传入神经的组中,即使是最小剂量的氯胺酮也能使MAP和IRSNA显著降低。仅在完全去传入神经的组中,最大剂量的氯胺酮使IPNA降低。另一方面,完全去传入神经组和迷走神经切断组的自主呼吸频率降低,但完全去传入神经组降低得更多。在神经轴完整的组中,最大剂量2 mg/kg氯胺酮引起的唯一显著变化是HR略有增加。我们得出结论,氯胺酮可直接抑制血管运动和呼吸中枢,并且这种抑制作用被外周感受器的传入输入所抵消。

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