Meissner A, Weber T P, Van Aken H, Weyand M, Booke M, Rolf N
Klinik und Poliklinik für Anästhesiologie und operative Intensivmedizin, Westfälische Wilhelms-Universität Münster, Germany.
J Cardiothorac Vasc Anesth. 1998 Dec;12(6):662-7. doi: 10.1016/s1053-0770(98)90239-7.
A beneficial effect of thoracic epidural anesthesia (TEA) on recovery from myocardial stunning was previously shown in awake dogs. The aim of this study was to investigate the effects of TEA on recovery from myocardial stunning in sevoflurane-anesthetized dogs.
Randomized animal study.
Animal laboratory of a university hospital.
Chronically instrumented mongrel dogs.
Six dogs were chronically instrumented for measurement of hemodynamics and myocardial wall thickening fraction (WTF). The following experiments were performed on separate days in a crossover fashion: (1) 10 minutes of ischemia of the left anterior descending (LAD) coronary artery during sevoflurane anesthesia without TEA and (2) 10 minutes of ischemia during sevoflurane anesthesia with TEA.
WTF was measured awake (baseline) and at predetermined time points until complete recovery of myocardial function occurred. Induction of anesthesia led to a decrease of WTF compared with baseline. Induction of ischemia led to a further decrease of WTF to negative values, which returned to positive values within the first minute of reperfusion. There were no differences between the two experimental conditions at any of the time points measured. In awake dogs, TEA improved the recovery from myocardial stunning compared with the control experiment. There was no difference between conscious dogs with TEA or sevoflurane-anesthetized dogs with or without TEA.
TEA has no additional protective effect on the recovery of WTF during sevoflurane anesthesia.
先前在清醒犬中已表明胸段硬膜外麻醉（TEA）对心肌顿抑恢复有有益作用。本研究旨在探讨TEA对七氟烷麻醉犬心肌顿抑恢复的影响。
随机动物研究。
大学医院的动物实验室。
长期植入仪器的杂种犬。
6只犬长期植入仪器以测量血流动力学和心肌壁增厚分数（WTF）。以下实验在不同日期以交叉方式进行：（1）七氟烷麻醉下无TEA时左前降支（LAD）冠状动脉缺血10分钟；（2）七氟烷麻醉下有TEA时缺血10分钟。
在清醒（基线）时及预定时间点测量WTF，直至心肌功能完全恢复。与基线相比，麻醉诱导导致WTF降低。缺血诱导导致WTF进一步降至负值，在再灌注的第一分钟内恢复为正值。在任何测量时间点，两种实验条件之间均无差异。在清醒犬中，与对照实验相比，TEA改善了心肌顿抑的恢复。有TEA的清醒犬与有或无TEA的七氟烷麻醉犬之间无差异。
在七氟烷麻醉期间，TEA对WTF的恢复没有额外的保护作用。
