Nakamura S, Hayashi K, Genda T, Nagasaka H, Aikawa K, Matsumoto N, Hori T
Department of Anesthesiology, Saitama Medical School.
Masui. 1998 Oct;47(10):1166-72.
In order to estimate primary action of anesthetic agents on the central neural mechanisms of respiratory control and the ventilatory response to an acute increased ETCO2, the effect of sevoflurane (SEV), isoflurane (ISO) or enflurane (ENF) on the pattern of phrenic nerve discharge (Phr.N.A.) was studied in adult rabbits which had been vagotomized, paralyzed and ventilated artificially with 100% oxygen. Throughout the course of experiment, ETCO2 and the rectal temperature of animals were maintained around physiological values. Depressant effects of these anesthetics on Phr. N.A. which consisted of inspiratory slope (SLO), peak amplitude (AMP), inspiratory (Ti) and expiratory (Te) time, I/E ratio (I/E) and respiratory cycle (Tc) were evaluated and compared with each anesthetic. At 0.5 MAC administration, SEV and ISO reduced SLO and AMP without a remarkable change in Tc, but ENF did with a prolongation in Tc. Inhalation of each anesthetic with 1 MAC caused a marked respiratory slowing with a more reduction of SLO and AMP than those occurred at 0.5 MAC; SEV increased Te more than Ti, but ENF prolonged Ti more than Te, while ISO enhanced both Ti and Te without any change of I/E. An acutely increased ETCO2 after the respiratory arrest (RA test) induced the change of Phr.N.A which was characterized by a marked prolongation in Tc with a prolonged Te, an increased SLO and an augmented AMP. The prolonged Tc induced by RA test was diminished by the inhalation of anesthetics, and a new response, shortening in Ti was produced by ENF and ISO. Based on these results, it might be concluded that there are both quantitative and qualitative differences in these anesthetic effects on the central pattern generator of respiration and the mechanism of CO2 responses at equipotent anesthetic concentrations.
为了评估麻醉剂对呼吸控制中枢神经机制以及急性呼气末二氧化碳(ETCO2)升高时通气反应的主要作用,在成年家兔中研究了七氟醚(SEV)、异氟醚(ISO)或安氟醚(ENF)对膈神经放电模式(Phr.N.A.)的影响。这些家兔已进行迷走神经切断术、肌肉松弛,并以100%氧气进行人工通气。在整个实验过程中,动物的ETCO2和直肠温度维持在生理值附近。评估了这些麻醉剂对Phr.N.A.的抑制作用,该作用由吸气斜率(SLO)、峰值幅度(AMP)、吸气时间(Ti)和呼气时间(Te)、I/E比值(I/E)以及呼吸周期(Tc)组成,并将每种麻醉剂进行了比较。给予0.5MAC时,SEV和ISO降低了SLO和AMP,而Tc无明显变化,但ENF降低SLO和AMP时Tc延长。给予1MAC吸入每种麻醉剂均导致明显的呼吸减慢,SLO和AMP的降低比给予0.5MAC时更明显;SEV使Te的增加多于Ti,但ENF使Ti的延长多于Te,而ISO使Ti和Te均增加,I/E无变化。呼吸停止后急性升高ETCO2(RA试验)诱导了Phr.N.A.的变化,其特征为Tc明显延长,Te延长,SLO增加,AMP增大。RA试验诱导的Tc延长可被吸入麻醉剂减轻,ENF和ISO产生了新的反应,即Ti缩短。基于这些结果,可能得出结论:在等效麻醉浓度下,这些麻醉剂对呼吸中枢模式发生器和CO2反应机制的影响在数量和质量上均存在差异。