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氟烷对迷走神经切断犬膈神经对急性缺氧反应的剂量依赖性效应。

Dose-dependent effects of halothane on the phrenic nerve responses to acute hypoxia in vagotomized dogs.

作者信息

Stuth E A, Dogas Z, Krolo M, Kampine J P, Hopp F A, Zuperku E J

机构信息

Department of Anesthesiology, Medical College of Wisconsin and the Zablocki Veterans Administration Medical Center, Milwaukee 53295, USA.

出版信息

Anesthesiology. 1997 Dec;87(6):1428-39. doi: 10.1097/00000542-199712000-00022.

Abstract

BACKGROUND

Previous studies in dogs and humans suggest that the carotid body chemoreceptor response to hypoxia is selectively impaired by halothane. The present studies in an open-loop canine preparation were performed to better delineate the effects of anesthetic concentrations of halothane on the carotid body chemoreceptor-mediated phrenic nerve response to an acute hypoxic stimulus.

METHODS

Three protocols were performed to study the effects of halothane anesthesia on the phrenic nerve response to 1 min of isocapnic hypoxia (partial pressure of oxygen [PaO2] at peak hypoxia, 35-38 mmHg) in unpremedicated, anesthetized, paralyzed, vagotomized dogs during constant mechanical ventilation. In protocol 1, the dose-dependent effects of halothane from 0.5-2.0 minimum alveolar concentration (MAC) on the hypoxic response during moderate hypercapnia (partial pressure of carbon dioxide [PaCO2], 60-65 mmHg) were studied in 10 animals. In protocol 2, the hypoxic responses at 1 MAC halothane near normocapnia (PaCO2, 40-45 mmHg) and during moderate hypercapnia were compared in an additional four animals. In protocol 3, the hypoxic response of 4 of 10 dogs from protocol 1 was also studied under sodium thiopental (STP) anesthesia after they completed protocol 1.

RESULTS

Protocol 1: Peak phrenic nerve activity (PPA) increased significantly during the hypoxic runs compared with the isocapnic hyperoxic controls at all halothane doses. The phrenic nerve response to the hypoxic stimulus was present even at the 2 MAC dose. Protocol 2: The net hypoxic responses for the two carbon dioxide background levels at 1 MAC were not significantly different. Protocol 3: The net hypoxic response of PPA for the STP anesthetic was not significantly different from the 1 MAC halothane dose. Bilateral carotid sinus denervation abolished the PPA response to hypoxia.

CONCLUSIONS

The phrenic nerve response to an acute, moderately severe isocapnic hypoxic stimulus is dose-dependently depressed but not abolished by surgical doses of halothane. This analysis does not suggest a selective depression of the carotid body chemoreceptor response by halothane. The observed hypoxic phrenic response was mediated by the carotid body chemoreceptors in vagotomized dogs because bilateral carotid sinus denervation abolished all increases in PPA.

摘要

背景

先前在犬类和人类中的研究表明,氟烷可选择性损害颈动脉体化学感受器对低氧的反应。本研究在开环犬类制备模型中进行,以更好地描绘麻醉浓度的氟烷对颈动脉体化学感受器介导的膈神经对急性低氧刺激反应的影响。

方法

在持续机械通气期间,对未用药、麻醉、麻痹、迷走神经切断的犬进行了三个实验方案,以研究氟烷麻醉对膈神经对1分钟等碳酸血症性低氧(低氧峰值时的氧分压[PaO2],35 - 38 mmHg)反应的影响。在实验方案1中,在10只动物中研究了氟烷从0.5 - 2.0最低肺泡浓度(MAC)在中度高碳酸血症(二氧化碳分压[PaCO2],60 - 65 mmHg)期间对低氧反应的剂量依赖性影响。在实验方案2中,在另外4只动物中比较了在接近正常碳酸血症(PaCO2,40 - 45 mmHg)和中度高碳酸血症时1 MAC氟烷下的低氧反应。在实验方案3中,在完成实验方案1后,对实验方案1中的10只犬中的4只在硫喷妥钠(STP)麻醉下也进行了低氧反应研究。

结果

实验方案1:与等碳酸血症性高氧对照相比,在所有氟烷剂量下,低氧期间膈神经活动峰值(PPA)显著增加。即使在2 MAC剂量下,膈神经对低氧刺激的反应仍然存在。实验方案2:在1 MAC时,两种二氧化碳背景水平下的净低氧反应无显著差异。实验方案3:STP麻醉下PPA的净低氧反应与1 MAC氟烷剂量无显著差异。双侧颈动脉窦去神经支配消除了PPA对低氧的反应。

结论

膈神经对急性、中度严重的等碳酸血症性低氧刺激的反应呈剂量依赖性降低,但未被手术剂量的氟烷消除。该分析未提示氟烷对颈动脉体化学感受器反应有选择性抑制作用。观察到的低氧膈神经反应是由迷走神经切断犬的颈动脉体化学感受器介导的,因为双侧颈动脉窦去神经支配消除了PPA的所有增加。

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