Rolf N, Van Aken H
Klinik und Poliklinik für Anästhesiologie und operative Intensivmedizin, Westfälischen Wilhelms-Universität Münster.
Anaesthesist. 1996 Feb;45 Suppl 1:S14-21.
The cardiovascular effects of sevoflurane as published from clinical and experimental studies are reviewed with respect to general haemodynamics and organ perfusion. Sevoflurane appears to be quite similar to isoflurane, with some minor exceptions. In adult patients and volunteers, sevoflurane has not been associated with increases in heart rate, whereas isoflurane and desflurane caused significant increases in heart rate at higher concentrations. The coronary vasodilatory potency of sevoflurane appears to be lower than that of isoflurane, and sevoflurane has not been associated with a reduction of blood flow to collateral-dependent myocardium in dogs with steal-prone anatomy. In several multi-center studies where patients with coronary artery disease or at high risk for coronary artery disease were randomised to receive either sevoflurane or isoflurane for cardiac or non-cardiac surgery, the incidence of myocardial ischaemia and infarction did not differ between treatment groups. In both human and animal models, sevoflurane preserves cerebral blood flow and reduces cerebral metabolic rate much like isoflurane. Considering its favourable pharmacokinetic properties, the introduction of sevoflurane into clinical practice appears to be a promising extension of the anaesthetic spectrum.
本文就七氟醚对全身血流动力学和器官灌注的影响，对已发表的临床和实验研究进行综述。七氟醚似乎与异氟醚非常相似，只有一些小的例外。在成年患者和志愿者中，七氟醚与心率增加无关，而异氟醚和地氟醚在较高浓度时会导致心率显著增加。七氟醚的冠状动脉扩张效力似乎低于异氟醚，并且在具有易发生窃血解剖结构的犬中，七氟醚与侧支依赖心肌的血流减少无关。在几项多中心研究中，将冠状动脉疾病患者或冠状动脉疾病高危患者随机分组，在心脏或非心脏手术中接受七氟醚或异氟醚，治疗组之间心肌缺血和梗死的发生率没有差异。在人类和动物模型中，七氟醚与异氟醚一样，能维持脑血流量并降低脑代谢率。考虑到其良好的药代动力学特性，七氟醚引入临床实践似乎是麻醉谱的一个有前景的扩展。
