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氟烷、恩氟烷和异氟烷对犬缺氧通气反应的抑制作用。

Depression of hypoxic ventilatory response by halothane, enflurane and isoflurane in dogs.

作者信息

Hirshman C A, McCullough R E, Cohen P J, Weil J V

出版信息

Br J Anaesth. 1977 Oct;49(10):957-63. doi: 10.1093/bja/49.10.957.

Abstract

The ventilatory responses to isocapnic hypoxia and hypercapnia were studied in six dogs each with a tracheostomy, awake and during anaesthesia with halothane, enflurane and isoflurane (1-2.5 MAC). Isocapnic hypoxic ventilatory response (HVR) was expressed as the parameter A, such that the greater the value of A, the greater the hypoxic response. In the anaesthetized dogs HVR (A) was reduced significantly from the awake value of 2010 +/- 172 (mean + SEM) to 630 +/- 173 by 1 MAC halothane, 495 +/- 105 by 1 MAC enflurane and 952 +/- 157 by 1 MAC isoflurane (PL0.05). All three anaesthetic agents produced significant depression of HUR at 1 MAC, but enflurane was more depressant than isoflurane. At 1.5 MAC all three anaesthetics produced equal and significant depression of HVR at equianalgesic concentrations. Further increases in anaesthetic concentration caused no increase in depression. Hypercapnic drive, as measured by the slope of the VE/PACO2 response curve, was reduced significantly from 9.75 litre min-1 kPa-1 +/- 2.4 in awake dogs to 0.83 +/- 0.56 after 1 MAC halothane, 0.68 +/- 0.53 after 1 MAC enflurane and 1.58 +/- 0.75 after 1 MAC isoflurane. In addition, hypercapnia-induced augmentation of the hypoxic drive was abolished by 1 MAC halothane or enflurane and diminished markedly by 1 MAC isoflurane. It may be clinically significant that hypoxia and hypercapnia during anaesthesia with these agents did not produce optimal stimulation of ventilation.

摘要

在六只均行气管切开术的犬中,研究了清醒状态以及在氟烷、恩氟烷和异氟烷(1 - 2.5MAC)麻醉期间,对等碳酸血症性低氧和高碳酸血症的通气反应。等碳酸血症性低氧通气反应(HVR)用参数A表示,A值越大,低氧反应越强。在麻醉犬中,HVR(A)从清醒时的2010±172(均值±标准误)显著降低,1MAC氟烷使其降至630±173,1MAC恩氟烷使其降至495±105,1MAC异氟烷使其降至952±157(P<0.05)。所有三种麻醉药在1MAC时均使HVR显著降低,但恩氟烷的抑制作用比异氟烷更强。在1.5MAC时,在等效镇痛浓度下,所有三种麻醉药对HVR产生同等程度的显著抑制。麻醉浓度进一步增加并未导致抑制作用增强。通过VE/PACO2反应曲线斜率测量的高碳酸血症驱动,从清醒犬的9.75升·分钟-1·千帕-1±2.4显著降低至1MAC氟烷后的0.83±0.56,1MAC恩氟烷后的0.68±0.53,1MAC异氟烷后的1.58±0.75。此外,1MAC氟烷或恩氟烷消除了高碳酸血症诱导的低氧驱动增强,1MAC异氟烷使其明显减弱。使用这些药物麻醉期间的低氧和高碳酸血症未产生最佳通气刺激,这在临床上可能具有重要意义。

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