Nishikawa T, Naito H
Department of Anesthesiology, Institute of Clinical Medicine, University of Tsukuba, Japan.
Anesthesiology. 1996 Mar;84(3):672-85. doi: 10.1097/00000542-199603000-00023.
Hypoxia or hypercapnia elicits cardiovascular responses associated with increased plasma catecholamine concentrations, whereas clonidine, an alpha(2)- adrenergic agonist, decreases plasma catecholamine concentrations. The authors examined whether systemic clonidine administration would alter the hemodynamic and catecholamine responses to hypoxia or hypercapnia in anesthetized dogs.
Pentobarbital-anesthetized dogs whose lungs were mechanically ventilated were instrumented for measurement of mean arterial pressure, heart rate, mean pulmonary artery pressure, right atrial pressure, cardiac output, left ventricular end-diastolic pressure, and the peak of first derivative of left ventricular pressure. The dogs were randomly assigned to receive an intravenous bolus injection of 10 microg/kg clonidine followed by continous infusion at a rate of 1 microg. kg (-1). min (-1)(clonidine-10 group, n = 7), an intravenous bolus injection of microg/kg clonidine followed by continuous infusion at a rate of 0.5 micro.kg(-).min(-1)(clonidine-5 group, n = 7), or an equivalent volume of 0.9% saline (control group = 7). Each dog underwent random challenges of hypoxia (PaO2 30, 40, and 50 mmHg) and hypercapnia (PaCO2 60, 80, and 120 mmHg). Measurements of hemodynamic and plasma norepinephrine and epinephrine concentrations were made after the loading dose of clonidine and the first and the second exposure of hypoxia or hypercapnia.
Although significant increases from prehypoxic values in mean arterial pressure (39 +/- 10 mmHg) and plasma norepinephrine (291 +/- 66 pg/ml) and epinephrine (45 +/- 22 pg/ml) concentrations were noted during hypoxia of PaO2 30, mmHg in the control group (P<0.05), such changes were absent in both clonidine groups. During hypercapnia of PaCo2 120 mmHg, changes from prehypercapnic values in mean arterial pressure, mean pulmonary artery pressure, the peak of first derivative of left ventricular pressure, and plasma norepinephrine and epinephrine concentrations in the clonidine-10 and clonidine-5 groups were significantly less than those in the control group. Plasma clonidine concentrations in the clonidine-10 and clonidine-5 groups were 16.8 +/- 1.7 and 8.9 =/- 1.0, 42.5 =/- 2.9 and 21.5 +/- 1.5, and 51.1 +/- 3.2 and 26.7 +/- 1.0 ng/ml after the loading dose of clonidine and the first and the second exposure of hypoxia or hypercapnia, respectively.
Systemic clonidine administration alter the hemodynamic changes associated with hypoxia or hypercapnia and suppresses plasma catecholamine responses in anesthetized dogs when a larger dose of clonidine is administered. catecholamines: epinephrine; norepinephrine.)
低氧或高碳酸血症会引发与血浆儿茶酚胺浓度升高相关的心血管反应,而α₂肾上腺素能激动剂可乐定可降低血浆儿茶酚胺浓度。作者研究了全身给予可乐定是否会改变麻醉犬对低氧或高碳酸血症的血流动力学和儿茶酚胺反应。
对戊巴比妥麻醉、机械通气的犬进行仪器植入,以测量平均动脉压、心率、平均肺动脉压、右心房压、心输出量、左心室舒张末期压以及左心室压力一阶导数峰值。将犬随机分为三组,分别接受静脉推注10μg/kg可乐定,随后以1μg·kg⁻¹·min⁻¹的速率持续输注(可乐定-10组,n = 7);静脉推注5μg/kg可乐定,随后以0.5μg·kg⁻¹·min⁻¹的速率持续输注(可乐定-5组,n = 7);或等量的0.9%生理盐水(对照组,n = 7)。每只犬随机接受低氧(动脉血氧分压30、40和50mmHg)和高碳酸血症(动脉血二氧化碳分压60、80和120mmHg)刺激。在给予可乐定负荷剂量后以及首次和第二次低氧或高碳酸血症暴露后,测量血流动力学以及血浆去甲肾上腺素和肾上腺素浓度。
尽管在对照组中,当动脉血氧分压为30mmHg进行低氧刺激时,平均动脉压(39±10mmHg)、血浆去甲肾上腺素(291±66pg/ml)和肾上腺素(45±22pg/ml)浓度较低氧前值显著升高(P<0.05),但在两个可乐定组中未出现此类变化。在动脉血二氧化碳分压为120mmHg进行高碳酸血症刺激时,可乐定-10组和可乐定-5组的平均动脉压、平均肺动脉压、左心室压力一阶导数峰值以及血浆去甲肾上腺素和肾上腺素浓度相对于高碳酸血症前值的变化显著小于对照组。可乐定-10组和可乐定-5组在给予可乐定负荷剂量后以及首次和第二次低氧或高碳酸血症暴露后的血浆可乐定浓度分别为16.8±1.7和8.9±1.0、42.5±2.9和21.5±1.5、51.1±3.2和26.7±1.0ng/ml。
全身给予可乐定可改变与低氧或高碳酸血症相关的血流动力学变化,并在给予较大剂量可乐定时抑制麻醉犬的血浆儿茶酚胺反应。(儿茶酚胺:肾上腺素;去甲肾上腺素。)