Comparison of low concentrations of halothane and isoflurane as bronchodilators.
Comparison of low concentrations of halothane and isoflurane as bronchodilators.
复制标题
低浓度氟烷和异氟烷作为支气管扩张剂的比较。
DOI：
10.1097/00000542-199306000-00012
复制
发表时间：
1993
期刊：
影响因子：
8.8
通讯作者：
Hirshman,CA
中科院分区：
文献类型：
--
作者：
Brown,RH;Zerhouni,EA;Hirshman,CA
虽然目前使用的所有高浓度吸入麻醉剂都被认为是良好的支气管扩张剂，但使用传统的气道张力测量方法的研究未能显示在使用氟烷、安氟烷和异氟烷期间气道反应性的差异。使用一种更灵敏的技术，作者比较了氟烷和异氟烷在相同MAC浓度下扩张组胺收缩气道的能力。方法采用高分辨率计算机断层扫描（HRCT）直接测量组胺收缩的个体气道对增加氟烷和异氟烷剂量的反应。在5只狗身上进行了15项研究。所有狗最初用硫喷妥钠15mg /kg麻醉，随后用10mg麻醉。Kg-1 x h-1维持剂量。气管插管后，对肺进行机械通气（15ml /kg, 15bpm）。静脉注射组胺200微克/分，气道收缩。随后，在隔天，狗接受增加浓度的氟烷或异氟烷（0.6、1.1和1.7 MAC）。在组胺输注后的另一天，狗接受0.2 mg/kg的阿托品，重复研究。结果水仙胺使气道面积减小34+/-2.5%（平均+/-SEM）。当氟烷和异氟烷浓度分别为0.6、1.1和1.7 MAC时，所有预收缩气道均表现出明显的剂量依赖性扩张。氟烷在0.6和1.1 MAC时比异氟烷更显著地扩张气道（P< 0.001）。这种效果在直径小于3毫米的气道中最为明显。在1.7 MAC时，两种药物之间无显著差异（P= 0.42）。阿托品（0.2 mg/kg）可逆转组胺引起的气道收缩。使用阿托品后，组胺-预缩气道面积增加370+/-34%（P< 0.0001）。结论氯烷和异氟醚对组胺收缩气道有剂量依赖性扩张作用。然而，在低浓度下，氟烷是一种比异氟烷更有效的支气管扩张剂。
BackgroundAlthough high concentrations of all currently used inhalational anesthetics are thought to be good bronchodilators, studies using traditional measures of airway tone fail to show differences in airway responsiveness during halothane, enflurane, and isoflurane use. Using a more sensitive technique, the authors compared the ability of halothane and isoflurane to dilate histamine-constricted airways at equivalent MAC concentrations.MethodsResponses of histamine-constricted individual airways to increasing doses of halothane and isoflurane were directly measured using high-resolution computed tomography (HRCT). Fifteen studies were performed in five dogs. All dogs were initially anesthetized with thiopental 15 mg/kg followed by a 10-mg. kg-1 x h-1 maintenance dose. Following tracheal intubation, the lungs were mechanically ventilated (15 ml/kg, 15 bpm). The airways were constricted with intravenous histamine 200 micrograms/min. On alternate days, the dogs subsequently received increasing concentrations of either halothane or isoflurane (0.6, 1.1, and 1.7 MAC). On a separate day, the dogs received atropine 0.2 mg/kg after the histamine infusion and the study was repeated.ResultsHistamine decreased airway area 34+/-2.5%(mean+/-SEM). All preconstricted airways showed a significant dose-dependent dilation to halothane and isoflurane at concentrations of 0.6, 1.1, and 1.7 MAC. Halothane significantly dilated airways to a greater extent than isoflurane at 0.6 and 1.1 MAC (P< 0.001). This effect was most pronounced in airways less than 3 mm in diameter. At 1.7 MAC, there was no significant difference between the two agents (P= 0.42). Atropine (0.2 mg/kg) reversed the airway constriction elicited by intravenous histamine. The histamine-preconstricted airways area increased 370+/-34%(P< 0.0001) after atropine.ConclusionsHalothane and isoflurane dilate histamine-constricted airways in a dose-dependent manner. However, at low concentrations, halothane was a more effective bronchodilator than isoflurane at equivalent MAC doses.