Hettrick D A, Pagel P S, Warltier D C
Department of Anesthesiology, Medical College of Wisconsin, Milwaukee 53226, USA.
Anesth Analg. 1996 Dec;83(6):1166-72. doi: 10.1097/00000539-199612000-00006.
The effects of volatile anesthetics on arterial mechanical properties in vivo are incompletely understood. The present investigation tested the hypothesis that isoflurane and halothane cause differential actions on the mechanical characteristics of the aorta in barbiturate-anesthetized dogs instrumented for measurement of aortic blood pressure, blood flow, and diameter. Aortic distensibility and characteristic aortic impedance were calculated from aortic diameter measurements. Oscillatory (Wo) and mean (Wm) hydraulic power were determined from aortic pressure and blood flow waveforms. Hemodynamics and aortic pressure, blood flow, and diameter were recorded before, during, and after 0.5, 0.75, and 1.0 minimum alveolar anesthetic concentration (MAC) (end-tidal) isoflurane (n = 7), or halothane (n = 8). Isoflurane and halothane caused significant (P < 0.05) and dose-related decreases in heart rate, mean arterial pressure, peak and end-diastolic aortic diameters, and aortic distensibility (e.g., from 0.16% +/- 0.03% during control to 0.24% +/- 0.04% mm Hg during 1.0 MAC isoflurane). Characteristic aortic impedance remained unchanged by either drug. In contrast to the findings with isoflurane, halothane increased the ratio of Wo to Wm (from 6.7 +/- 1.1 during control to 11.3 +/- 3.1 x 10(-2) during 1.0 MAC), suggesting that this drug decreases left ventricular mechanical efficiency. The results indicate that isoflurane and halothane do not alter characteristic aortic impedance and produce similar increases in aortic distensibility concomitant with reductions in aortic pressure. These findings support the contention that volatile anesthetic-induced alterations in aortic mechanical properties do not contribute to the differential effects of these drugs on left ventricular afterload in vivo.
挥发性麻醉药对体内动脉力学特性的影响尚未完全明确。本研究检验了以下假设:在用于测量主动脉血压、血流量和直径的巴比妥类麻醉犬中,异氟烷和氟烷对主动脉的力学特性有不同作用。根据主动脉直径测量值计算主动脉扩张性和特征性主动脉阻抗。从主动脉压力和血流波形确定振荡(Wo)和平均(Wm)水力功率。在0.5、0.75和1.0最低肺泡麻醉浓度(MAC)(呼气末)异氟烷(n = 7)或氟烷(n = 8)给药前、给药期间和给药后记录血流动力学以及主动脉压力、血流量和直径。异氟烷和氟烷导致心率、平均动脉压、主动脉峰值和舒张末期直径以及主动脉扩张性显著(P < 0.05)且与剂量相关的降低(例如,在对照期间为0.16%±0.03%,在1.0 MAC异氟烷期间为0.24%±0.04% mmHg)。两种药物均未改变特征性主动脉阻抗。与异氟烷的结果相反,氟烷增加了Wo与Wm的比值(从对照期间的6.7±1.1增加到1.0 MAC期间的11.3±3.1×10⁻²),表明该药降低了左心室机械效率。结果表明,异氟烷和氟烷不会改变特征性主动脉阻抗,并且在主动脉压力降低的同时使主动脉扩张性产生类似的增加。这些发现支持了以下观点:挥发性麻醉药引起的主动脉力学特性改变不会导致这些药物在体内对左心室后负荷产生不同影响。