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三磷酸腺苷敏感性钾通道在氟烷、异氟烷和恩氟烷引起的冠状动脉舒张中的作用

Role of adenosine triphosphate-sensitive potassium channels in coronary vasodilation by halothane, isoflurane, and enflurane.

作者信息

Crystal G J, Gurevicius J, Salem M R, Zhou X

机构信息

Department of Anesthesiology, Illinois Masonic Medical Center, University of Illinois, College of Medicine, Chicago 60657-5193, USA.

出版信息

Anesthesiology. 1997 Feb;86(2):448-58. doi: 10.1097/00000542-199702000-00020.

Abstract

BACKGROUND

Halothane, isoflurane, and enflurane cause coronary vasodilation and cardiac depression. This study was performed to assess the role of adenosine triphosphate (ATP)-sensitive potassium channels (KATP channels) in these effects.

METHODS

Twenty-five thoracotomized dogs were anesthetized with fentanyl and midazolam. The left anterior descending coronary artery was perfused via either of two pressurized (80 mmHg) reservoirs. One reservoir was supplied with arterial blood free of a volatile anesthetic, and the second reservoir was supplied with arterial blood equilibrated in an oxygenator with a 1 minimum alveolar concentration of either halothane (0.9%, n = 10), isoflurane (1.4%, n = 8), or enflurane (2.2%, n = 7). Coronary blood flow (CBF) was measured using a Doppler flow transducer, and segmental shortening (SS) was measured with ultrasonic crystals. Responses to the volatile anesthetics were assessed under control conditions, during intracoronary infusion of the KATP channel inhibitor glibenclamide (100 micrograms/min), and after cessation of glibenclamide (recovery). The effectiveness of glibenclamide was verified from inhibition of coronary vasodilator responses to the KATP channel opener cromakalim without effect on those to the KATP channel-independent vasodilators, sodium nitroprusside and acetylcholine.

RESULTS

Under control conditions, the volatile anesthetics caused pronounced increases in CBF (isoflurane > halothane = enflurane), and decreases in SS (enflurane > halothane = isoflurane). Glibenclamide blunted significantly (and reversibly) the increases in CBF, but it had no effect on the decreases in SS.

CONCLUSIONS

The KATP channels play an important role in coronary vasodilation but apparently are not involved in cardiac depression caused by halothane, isoflurane, and enflurane in canine hearts in situ.

摘要

背景

氟烷、异氟烷和恩氟烷可引起冠状动脉舒张及心脏抑制。本研究旨在评估三磷酸腺苷(ATP)敏感性钾通道(KATP通道)在这些效应中的作用。

方法

25只开胸犬用芬太尼和咪达唑仑麻醉。通过两个加压(80 mmHg)储液器之一灌注左前降支冠状动脉。一个储液器供应不含挥发性麻醉剂的动脉血,第二个储液器供应在氧合器中平衡至1个最低肺泡浓度的氟烷(0.9%,n = 10)、异氟烷(1.4%,n = 8)或恩氟烷(2.2%,n = 7)的动脉血。使用多普勒血流换能器测量冠状动脉血流量(CBF),并用超声晶体测量节段缩短(SS)。在对照条件下、冠状动脉内输注KATP通道抑制剂格列本脲(100微克/分钟)期间以及格列本脲停用后(恢复)评估对挥发性麻醉剂的反应。通过抑制冠状动脉对KATP通道开放剂克罗卡林的舒张反应来验证格列本脲的有效性,而对KATP通道非依赖性血管舒张剂硝普钠和乙酰胆碱的反应无影响。

结果

在对照条件下,挥发性麻醉剂导致CBF显著增加(异氟烷>氟烷 = 恩氟烷),SS降低(恩氟烷>氟烷 = 异氟烷)。格列本脲显著(且可逆地)减弱了CBF的增加,但对SS的降低无影响。

结论

KATP通道在冠状动脉舒张中起重要作用,但显然不参与氟烷、异氟烷和恩氟烷对犬原位心脏的心脏抑制作用。

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