Iida H, Ohata H, Iida M, Watanabe Y, Dohi S
Department of Anesthesiology and Critical Care Medicine, Gifu University School of Medicine, Japan.
Anesthesiology. 1998 Oct;89(4):954-60. doi: 10.1097/00000542-199810000-00020.
Activation of adenosine triphosphate-sensitive K+ channels causes cerebral vasodilation. To assess their contribution to volatile anesthetic-induced cerebral vasodilation, the effects of glibenclamide, an adenosine triphosphate-sensitive K+ channel blocker, on the cerebral vasodilation induced by isoflurane and sevoflurane were studied.
Pentobarbital-anesthetized dogs (n = 24) assigned to one of two groups were prepared for measurement of pial vessel diameter using a cranial window preparation. Each dog received three minimum alveolar concentrations (MAC; 0.5, 1, and 1.5 MAC) of either isoflurane or sevoflurane, and the pial arteriolar diameters were measured in the presence or absence of glibenclamide (10(-5) M) infused continuously into the window. Mean arterial pressure was maintained with phenylephrine. Furthermore, to assess the direct effect of isoflurane and sevoflurane on cerebral vessels, artificial cerebrospinal fluid was administered topically by being bubbled with isoflurane or sevoflurane. The blocking effect of glibenclamide on the vasoactive effects of these anesthetics also were evaluated.
Isoflurane and sevoflurane both significantly dilated large (> or = 100 microm) and small (< 100 microm) pial arterioles in a concentration-dependent manner (6% and 10%, 3% and 8% for 0.5 MAC; 10% and 19%, 7% and 14% for 1 MAC; 17% and 28%, 13% and 25% for 1.5 MAC). Glibenclamide attenuated the arteriolar dilation induced by these anesthetics (not significant in isoflurane). Topical application of isoflurane or sevoflurane dilated large and small arterioles both in a concentration-dependent manner. Such vasodilation was inhibited completely by glibenclamide.
The vasodilation of cerebral pial vessels induced by isoflurane and sevoflurane appears to be mediated, at least in part, via activation of adenosine triphosphate-sensitive K+ channels.
三磷酸腺苷敏感性钾通道的激活可引起脑血管舒张。为评估其在挥发性麻醉药诱导的脑血管舒张中的作用,研究了三磷酸腺苷敏感性钾通道阻滞剂格列本脲对异氟烷和七氟烷诱导的脑血管舒张的影响。
将戊巴比妥麻醉的犬(n = 24)分为两组,采用颅骨开窗法准备测量软脑膜血管直径。每只犬接受三种最低肺泡有效浓度(MAC;0.5、1和1.5 MAC)的异氟烷或七氟烷,并在持续向窗内注入格列本脲(10⁻⁵ M)的情况下或未注入时测量软脑膜小动脉直径。用去氧肾上腺素维持平均动脉压。此外,为评估异氟烷和七氟烷对脑血管的直接作用,用异氟烷或七氟烷鼓泡人工脑脊液并局部给药。还评估了格列本脲对这些麻醉药血管活性作用的阻断效果。
异氟烷和七氟烷均以浓度依赖性方式使大(≥100微米)、小(<100微米)软脑膜小动脉显著舒张(0.5 MAC时分别为6%和10%,3%和8%;1 MAC时分别为10%和19%,7%和14%;1.5 MAC时分别为17%和28%,13%和25%)。格列本脲减弱了这些麻醉药诱导的小动脉舒张(在异氟烷中不显著)局部应用异氟烷或七氟烷均以浓度依赖性方式使大、小动脉舒张。这种血管舒张被格列本脲完全抑制。
异氟烷和七氟烷诱导的软脑膜脑血管舒张似乎至少部分是通过三磷酸腺苷敏感性钾通道的激活介导的。