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影响犬体外循环后最低肺泡有效浓度降低的因素。

Factors influencing MAC reduction after cardiopulmonary bypass in dogs.

作者信息

Neumeister M W, Li G, Williams G, Doak G, Sullivan J A, Hall R I

机构信息

Department of Anaesthesia, Dalhousie University, Halifax, Nova Scotia, Canada.

出版信息

Can J Anaesth. 1997 Oct;44(10):1120-6. doi: 10.1007/BF03019237.

Abstract

BACKGROUND

Anaesthetic requirements may be reduced following surgery employing cardiopulmonary bypass (CPB). This study, in dogs, determined the role of a) volatile agents (enflurane [E] vs isoflurane [I]), b) oxygenator (bubble [B] vs membrane [M]), and c) presence [FL] vs absence [NoFL] of an in-line arterial filter in the bypass circuit in altering anaesthetic requirements following CPB.

METHODS

Male mongrel dogs were anaesthetized with either enflurane (n = 24) or isoflurane (n = 24). They were randomly assigned to one of eight groups (n = 6 per group); Group 1 (E/B/FL), Group 2 (E/M/FL), Group 3 (E/M/NoFL), Group 4 (E/B/NoFL), Group 5 (I/M/FL), Group 6 (I/B/FL), Group 7 (I/M/NoFL) or Group 8 (I/B/NoFL). MAC was determined using the tail-clamp method at hourly intervals, twice before and three times after a one hour normothermic perfusion using aortoatrial cannulation and CPB.

RESULTS

Prior to CPB, MAC was reproducible (enflurane: MAC1 2.17 +/- 0.29 vs MAC2 2.14 +/- 0.28%; isoflurane: MAC1 1.42 +/- 0.31 vs MAC2 1.41 +/- 0.33%) and differed among groups only for the volatile agent employed. Following CPB, MAC was reduced in all groups (P < 0.05 vs pre-CPB measurements) except Group 1 (E/B/FL). The degree of MAC reduction in other groups ranged from 39-64% and was not different based on type of agent employed, use of a membrane or bubble oxygenator, or presence or absence of an in-line arterial filter.

CONCLUSION

In dogs, MAC reduction following CPB was variable, not related to type of volatile agent employed, use of a membrane or bubble oxygenator, or presence or absence of an in-line arterial filter. The explanation for reductions in anaesthetic requirements following CPB in this model remains speculative.

摘要

背景

在采用体外循环(CPB)的手术后,麻醉需求可能会降低。本研究以犬为实验对象,确定了以下因素的作用:a)挥发性麻醉剂(安氟醚[E]与异氟醚[I]),b)氧合器(鼓泡式[B]与膜式[M]),以及c)旁路循环中有无在线动脉滤器[FL]与无[NoFL]对CPB后麻醉需求变化的影响。

方法

雄性杂种犬分别用安氟醚(n = 24)或异氟醚(n = 24)麻醉。它们被随机分为八组之一(每组n = 6);第1组(E/B/FL),第2组(E/M/FL),第3组(E/M/NoFL),第4组(E/B/NoFL),第5组(I/M/FL),第6组(I/B/FL),第7组(I/M/NoFL)或第8组(I/B/NoFL)。使用尾夹法每隔一小时测定一次最低肺泡有效浓度(MAC),在使用主动脉心房插管和CPB进行一小时常温灌注之前测定两次,之后测定三次。

结果

在CPB之前,MAC具有可重复性(安氟醚:MAC1为2.17±0.29%,MAC2为2.14±0.28%;异氟醚:MAC1为1.42±0.31%,MAC2为1.41±0.33%),且仅在所使用的挥发性麻醉剂方面各组有所不同。CPB之后,除第1组(E/B/FL)外,所有组的MAC均降低(与CPB前测量值相比,P < 0.05)。其他组的MAC降低程度在39%至64%之间,且与所使用的麻醉剂类型、膜式或鼓泡式氧合器的使用以及有无在线动脉滤器无关。

结论

在犬中,CPB后的MAC降低情况各不相同,与所使用的挥发性麻醉剂类型、膜式或鼓泡式氧合器的使用以及有无在线动脉滤器无关。在该模型中,CPB后麻醉需求降低的原因仍属推测。

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