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等效异氟烷和阿芬太尼/异氟烷最低肺泡浓度倍数对猫心血管系统的影响

Cardiovascular effects of equipotent isoflurane and alfentanil/isoflurane minimum alveolar concentration multiple in cats.

作者信息

Pascoe P J, Ilkiw J E, Fisher L D

机构信息

Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis 95616, USA.

出版信息

Am J Vet Res. 1997 Nov;58(11):1267-73.

PMID:9361891
Abstract

OBJECTIVE

To determine whether administration of opioids to anesthetized cats induced less cardiovascular depression than that induced by an equivalent amount of anesthetic alone, and to measure endocrine responses to a noxious stimulus.

ANIMALS

6 healthy female cats.

PROCEDURE

Anesthesia was induced with isoflurane and was maintained for 60 minutes at 1.3 isoflurane MAC. Blood gas tensions, pH, and plasma alfentanil and hormone concentrations, blood pressures, and cardiac output were measured. A noxious stimulus was applied for 5 minutes, while blood acquisition and measurements were repeated. Alfentanil was administered i.v. to achieve estimated plasma concentration of 500 ng/ml, and end-tidal isoflurane concentration was reduced by 35%. After another 60 minutes, blood was obtained and measurements were taken, then a second 5-minute noxious stimulus was applied while blood acquisition and measurements were retaken.

RESULTS

Alfentanil administration and reduction of isoflurane concentration significantly increased body temperature, heart rate, mean arterial pressure, mean pulmonary arterial pressure, stroke index, cardiac index, hemoglobin, oxygen delivery index, PvO2 and PvCO2, dopamine, epinephrine (EPI), norepinephrine (NOREPI), and cortisol values, and significantly decreased arterial and venous pH. Application of a noxious stimulus significantly increased heart rate, stroke index, cardiac index, PaO2, oxygen delivery index, arterial and venous pH, and NOREPI values, and decreased bicarbonate, PaCO2, PvCO2, and EPI values. Alfentanil administration blunted cardiac index, PaCO2, oxygen delivery index, arterial pH, PaO2, and EPI, and NOREPI responses to a noxious stimulus.

CONCLUSIONS

Compared with isoflurane alone, alfentanil administration and reduction of isoflurane MAC improved cardiovascular variables, and blunted respiratory, hormonal, and most hemodynamic responses to a noxious stimulus in cats.

CLINICAL RELEVANCE

Use of the balanced opioid anesthesia regimen induced some beneficial effects in healthy cats; effects were similar to, although greater in nature, than effects induced by a noxious stimulus.

摘要

目的

确定给麻醉猫使用阿片类药物是否比单独使用等量麻醉剂引起的心血管抑制更少,并测量对有害刺激的内分泌反应。

动物

6只健康雌性猫。

实验步骤

用异氟烷诱导麻醉,并在1.3倍异氟烷最低肺泡有效浓度(MAC)下维持60分钟。测量血气张力、pH值、血浆阿芬太尼和激素浓度、血压及心输出量。施加有害刺激5分钟,同时重复采血和测量。静脉注射阿芬太尼以达到估计血浆浓度500纳克/毫升,呼气末异氟烷浓度降低35%。再过60分钟后,采血并测量,然后施加第二次5分钟有害刺激,同时再次采血和测量。

结果

给予阿芬太尼并降低异氟烷浓度显著提高了体温、心率、平均动脉压、平均肺动脉压、每搏指数、心脏指数、血红蛋白、氧输送指数、混合静脉血氧分压(PvO2)和混合静脉血二氧化碳分压(PvCO2)、多巴胺、肾上腺素(EPI)、去甲肾上腺素(NOREPI)和皮质醇值,并显著降低动脉和静脉pH值。施加有害刺激显著提高了心率、每搏指数、心脏指数、动脉血氧分压(PaO2)、氧输送指数、动脉和静脉pH值以及去甲肾上腺素值,并降低了碳酸氢盐、动脉血二氧化碳分压(PaCO2)、混合静脉血二氧化碳分压和肾上腺素值。给予阿芬太尼减弱了心脏指数、动脉血二氧化碳分压、氧输送指数、动脉pH值、动脉血氧分压和肾上腺素以及去甲肾上腺素对有害刺激的反应。

结论

与单独使用异氟烷相比,给予阿芬太尼并降低异氟烷MAC改善了心血管变量,并减弱了猫对有害刺激的呼吸、激素和大多数血流动力学反应。

临床意义

平衡阿片类麻醉方案的使用在健康猫中产生了一些有益效果;其效果与有害刺激引起的效果相似,尽管在程度上更大。

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