Endothelium-dependent circulatory control--a mechanism for the differing peripheral vascular effects of isoflurane versus halothane.
Endothelium-dependent circulatory control--a mechanism for the differing peripheral vascular effects of isoflurane versus halothane.
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DOI：
10.1097/00000542-199212000-00020
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发表时间：
1992-12
期刊：
影响因子：
8.8
通讯作者：
Eric P. Greenblatt;A. Loeb;D. Longnecker
中科院分区：
文献类型：
--
作者：
Eric P. Greenblatt;A. Loeb;D. Longnecker
多项研究表明，氟烷和异氟醚可改变内皮依赖性血管扩张剂的反应，表明这些麻醉剂的不同循环效应可能部分归因于内皮细胞对血管张力控制的改变。本研究在等浓度异氟醚(n=6)或氟烷(n=8)麻醉下，观察内皮衍生松弛因子(EDRF/NO)在吲哚美辛麻醉大鼠循环控制中的作用。使用放射性标记微球，测量大脑、小脑、心脏、肾脏、胃肠道、脾、肝脏、骨骼肌、皮肤、耳朵以及白色和棕色脂肪的全身和局部血流动力学。测定给药前后心输出量、平均动脉压(MAP)、全身血管阻力(Svr)、局部血流量和局部血管阻力，分别给予L单甲基精氨酸(100 mg/kg)抑制EDRF/NO合成，L精氨酸(300 mg/kg)逆转L-NMMA的作用。在两组麻醉剂中，L-NMMA减少了心输出量，增加了脑、心、肾、脾、胃肠道、肝动脉、骨骼肌、皮肤和白色脂肪的MAP、SVR和局部阻力。尽管心输出量仍减少，但两组的室上性心动过速和平均动脉压均恢复到或低于控制值。在异氟醚麻醉期间，与氟烷麻醉相比，L-NMMA引起的血压(54+/-7%比24+/-2%)和SVR(143+/-22%比79+/-11%)显著增加。此外，异氟醚麻醉的大鼠心、肾、胃肠道、肝动脉和皮肤的血管阻力在L-NMMA后显著高于氟烷麻醉的大鼠。
Several studies have suggested that halothane and isoflurane modify responses to endothelium-dependent vasodilators, indicating that the differing circulatory effects of these anesthetics may be, in part, attributable to alterations in endothelial cell control of vascular tone. This study was designed to determine the contribution of endothelium-derived relaxing factor (EDRF/NO) to circulatory control in indomethacin-treated rats anesthetized with equipotent concentrations (1 MAC) of either isoflurane (n = 6) or halothane (n = 8). Using radiolabelled microspheres, systemic and regional hemodynamics were measured in cerebrum, cerebellum, heart, kidney, gastrointestinal tract, spleen, liver, skeletal muscle, skin, ear, and white and brown fat. Cardiac output, mean arterial pressure (MAP), systemic vascular resistance (SVR), regional blood flows, and regional vascular resistances were determined before (control) and after administration of NG-monomethyl-L-arginine (L-NMMA, 100 mg/kg) to inhibit EDRF/NO synthesis, and following L-arginine (300 mg/kg) to reverse the effects of L-NMMA. In both anesthetic groups, L-NMMA decreased cardiac output and increased MAP, SVR, and regional resistances in brain, heart, kidney, spleen, gastrointestinal tract, hepatic artery, skeletal muscle, skin, and white fat. L-arginine returned SVR and MAP to or below control values in both groups, although cardiac output remained decreased. During isoflurane as compared to halothane anesthesia, L-NMMA caused significantly greater increases in blood pressure (54 +/- 7% vs. 24 +/- 2%) and SVR (143 +/- 22% vs. 79 +/- 11%). In addition, rats anesthetized with isoflurane had significantly greater increases in vascular resistance in heart, kidney, gastrointestinal tract, hepatic artery, and skin after L-NMMA than did rats anesthetized with halothane.(ABSTRACT TRUNCATED AT 250 WORDS)