Wyon N, Eriksson L I, Yamamoto Y, Lindahl S G
Department of Anesthesiology, Linköping University Hospital, Sweden.
Anesth Analg. 1996 Jun;82(6):1252-6. doi: 10.1097/00000539-199606000-00026.
We investigated the effects of a close carotid injection of vecuronium on changes in phrenic nerve activity during different states of oxygenation. Experiments were performed on normothermic and mechanically ventilated adult New Zealand White rabbits with a tracheostomy under continuous thiopental infusion. Carotid arteries and carotid bodies were identified bilaterally followed by glomectomy on the contralateral side and positioning of a lingual artery catheter with its tip located in the carotid bifurcation on the ipsilateral side. From the dissected ipsilateral C-4 nerve root, changes in integrated phrenic nerve activity (IPA) were recorded after isocapnic step reductions from hyperoxia to normoxia (fraction of inspired oxygen [FIO2] 0.21, normoxic challenge) and from hyperoxia to moderate hypoxia (FIO2 0.15, hypoxic challenge) immediately after a close carotid bolus injection of either normal saline or 1 or 10 microgram of vecuronium. Arterial blood gases were analyzed during each ventilatory state. Phrenic nerve response to hypoxia expressed as chemosensitivity (Sch) was computed as the relative change in phrenic nerve activity per unit decrease in arterial oxygen saturation (Sao2), that is: Sch = (IPA challenge/IPA hyperoxia) - 1/Sao2 hyperoxia - Sao2 challenge. Hypoxic challenges were associated with reduced phrenic nerve response (Sch) after injection of 1 and 10 micrograms of vecuronium compared with normal saline. During normoxic challenges, no change occurred after 1 microgram, but reduced chemosensitivity was seen after 10 micrograms of vecuronium. We conclude that vecuronium depresses phrenic nerve activity during hypoxia.
我们研究了在不同氧合状态下,经颈动脉近距离注射维库溴铵对膈神经活动变化的影响。实验在成年新西兰白兔身上进行,这些兔子处于常温状态,接受机械通气,并施行气管切开术,持续输注硫喷妥钠。双侧识别颈动脉和颈动脉体,然后对侧进行颈动脉体切除术,并在同侧将舌动脉导管尖端置于颈动脉分叉处。从解剖的同侧C - 4神经根记录整合膈神经活动(IPA)的变化,即在经颈动脉快速推注生理盐水、1微克或10微克维库溴铵后,立即从高氧状态进行等碳酸性逐步降低至常氧状态(吸入氧分数[FIO2] 0.21,常氧刺激)以及从高氧状态至中度低氧状态(FIO2 0.15,低氧刺激)过程中的变化。在每种通气状态下分析动脉血气。膈神经对低氧的反应以化学敏感性(Sch)表示,计算方法为膈神经活动的相对变化除以动脉血氧饱和度(Sao2)的单位降低值,即:Sch =(刺激时的IPA / 高氧时的IPA)- 1 / 高氧时的Sao2 - 刺激时的Sao2。与注射生理盐水相比,注射1微克和10微克维库溴铵后,低氧刺激与膈神经反应(Sch)降低有关。在常氧刺激期间,注射1微克后无变化,但注射10微克维库溴铵后化学敏感性降低。我们得出结论,维库溴铵在低氧期间会抑制膈神经活动。