Effects of dexmedetomidine on systemic and coronary hemodynamics in the anesthetized dog.
Effects of dexmedetomidine on systemic and coronary hemodynamics in the anesthetized dog.
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DOI：
10.1016/1053-0770(93)90117-4
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发表时间：
1993-02-01
影响因子：
2.8
通讯作者：
Sagan, M
中科院分区：
文献类型：
--
作者：
Flacke, W E;Flacke, J W;Sagan, M
除了中枢效应，这是其麻醉学使用的基础，α2-肾上腺素能激动剂还具有直接的外周心血管效应。右美托咪定(DM)被发现对狗的心脏功能有抑制作用，即使在自主神经丧失后也是如此。本实验观察了在安氟醚麻醉下，DM对开胸犬冠脉流量、心肌氧摄取率和心功能的影响。测量并连续记录心率(HR)、平均动脉压(MAP)、左心室舒张末压(LVEDP)、左心室收缩压一阶导数(dp/dtmax)和左冠状动脉前降支(CBF)流量。每隔一段时间测定心输出量(CO)、血浆儿茶酚胺(CA)、血红蛋白和动脉血、混合静脉血和冠状静脉窦血氧饱和度。计算心脏指数(CI)、体循环血管阻力指数(SVRI)、冠脉局部血管阻力(CVR)、体循环[C(a-v)O2]和冠脉[C(a-cs)O2]氧浓度差。每隔20分钟静脉注射0.25、0.5、1.0、2.0和4.0微克/公斤的DM剂量。测量和样本是在药物效应高峰期和下一次服药之前进行的。糖尿病大鼠末次给药后给予α2-受体拮抗剂阿替帕唑0.5 mg/kg。DM引起SVRI、CVR、LVEDP、C(a-v)O2和C(a-cs)O2的即刻剂量依赖性增加，HR和CI下降，并在两次剂量之间恢复。Dp/dtmax在前两次给药后下降，之后随着血浆CA降至最低水平而稳定。阿替帕美唑完全逆转了所有的变化。(摘要截短250字)
In addition to central effects, which are the basis of their use in anesthesiology, alpha 2-adrenergic agonists have direct peripheral cardiovascular effects. Dexmedetomidine (DM) has been found to depress cardiac function in dogs, even after autonomic denervation. The present experiments evaluated the effects of DM on coronary flow, myocardial oxygen extraction, and cardiac function in intact, open chest dogs under enflurane anesthesia. Heart rate (HR), mean arterial pressure (MAP), left ventricular end-diastolic pressure (LVEDP), the first derivative of systolic left ventricular pressure (dP/dtmax), and flow in the left anterior descending coronary artery (CBF) were measured and continuously recorded. Cardiac output (CO), plasma catecholamines (CA), hemoglobin and oxygen saturation in arterial, mixed venous, and coronary sinus blood were measured at intervals. Cardiac index (CI), systemic vascular resistance index (SVRI), regional coronary vascular resistance (CVR), and oxygen concentration differences across the systemic [C(a-v)O2], and coronary [C(a-cs)O2] circulations were calculated. DM doses of 0.25, 0.5, 1.0, 2.0, and 4.0 micrograms/kg were given IV at 20-minute intervals. Measurements and samples were taken at peak drug effects and just prior to the next dose. The alpha 2-antagonist atipamezole, 0.5 mg/kg, was given after the last dose of DM. DM caused immediate dose-dependent increases in SVRI, CVR, LVEDP, C(a-v)O2, and C(a-cs)O2, and decreases in HR, and CI, with recovery between doses. DP/dtmax declined after the first two doses and stabilized thereafter, as plasma CA fell to minimal levels. Atipamezole completely reversed all changes.(ABSTRACT TRUNCATED AT 250 WORDS)