Takeda S, Ozawa Y, Tomaru T
Department of Anesthesiology, Showa University Fujigaoka Hospital, Yokohama, Japan.
Can J Anaesth. 1997 Sep;44(9):1002-7. doi: 10.1007/BF03011973.
The investigational agent, KRN2391, is a potassium channel opener with a nitrate moiety which possesses potent vasodilatory action. We compared the haemodynamic effect of KRN2391. Induced hypotension with those of nicardipine.
Sixteen dogs were anaesthetized with isoflurane 1.3% in oxygen (1 MAC). After the baseline period. mean arterial pressure (MAP) was decreased to 60 mmHg for 60 min with an infusion nicardipine (n = 8).
The KRN2391- and nicardipine-induced hypotension resulted in maximal decreased systemic vascular resistance of 35% and 25%, increases in cardiac index of 145% and 197%, and stroke volume index of 150% and 212%, respectively, (P < 0.01). There was no change in heart rate. Nicardipine was associated with increases (P < 0.01) in both right atrial and mean pulmonary artery pressures, whereas these variables remained unchanged with KRN2391. Pulmonary capillary wedge pressure decreased with KRN2391 (P < 0.01), but not with nicardipine.
While both drugs were equally able of inducing hypotension, our results show that the haemodynamic profile of KRN2391- and nicardipine-induced hypotension was a hyperdynamic state expressed by the marked increase in cardiac index with varying changes in right and left ventricular filling pressures, and suggest that KRN2391 may be a useful vasodilator for induced hypotension.
研究药物KRN2391是一种带有硝酸盐部分的钾通道开放剂,具有强大的血管舒张作用。我们比较了KRN2391诱导低血压与尼卡地平诱导低血压的血流动力学效应。
16只犬用1.3%异氟烷和氧气(1个最低肺泡有效浓度)麻醉。在基线期后,通过输注尼卡地平(n = 8)使平均动脉压(MAP)在60分钟内降至60 mmHg。
KRN2391和尼卡地平诱导的低血压分别导致全身血管阻力最大降低35%和25%,心脏指数分别增加145%和197%,每搏量指数分别增加150%和212%(P < 0.01)。心率无变化。尼卡地平使右心房压和平均肺动脉压均升高(P < 0.01),而KRN2391对这些指标无影响。KRN2391使肺毛细血管楔压降低(P < 0.01),而尼卡地平无此作用。
虽然两种药物诱导低血压的能力相同,但我们的结果表明,KRN2391和尼卡地平诱导低血压的血流动力学特征是一种高动力状态,表现为心脏指数显著增加,左右心室充盈压有不同变化,提示KRN2391可能是一种用于诱导低血压的有效血管扩张剂。