The Effects of Inhalation Anesthetics in Regional Myocardial Blood Distribution.

吸入麻醉药对局部心肌血液分布的影响。

• 批准号: 05671267
• 负责人: KITAHARA Hiroshi
• 金额: $ 1.34万
• 依托单位: Tokushima University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for General Scientific Research (C)
• 财政年份: 1993
• 资助国家: 日本
• 起止时间: 1993 至 1994
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-05671267/
• 关键词: Inhalation anesthetic; Myocardial contrast echocardiography; Myocardial ischemia; Coronary steal

In 9 mongrel dogs, myocardial contrast echocardiography (MCE) was performed from the heart surface. Sonicated 5% albumin solution (2ml) was infused into the left coronary artery. The following parameters were analyzed : (1) the peak gray level (PGL) corrected for background, (2) the time from injection to the peak (TTP), and (3) the contrast decay half-time (T1/2). Regions of interest (ROls) were designated in the inner and outer layrs of the areas supplied by the circumflex branch (CX) and the left anterior descending branch (LAD). Stensis of CX resulted in areduction of PGL in the CX area and a significant reduction in the ratio of PGL of the inner to that of the outer CX area (1/0 ratio). The ratio of PGL of the CX area to that of the LAD area (CX/LAD ratio) was also decreased significantly. Following inhalation of 1 MAC sevoflurane (Sev), the l/O ratio improved, while the CX/LAD ratio remained significantly reduced. When blood pressure was elevated by administration of phenylephrin … More e, the CX/LAD ratio improved. No significant change was observed in the TTP and T1/2.MCE was performed using transesophageal echocardiography in 9 patients undergoing coronary artery bypass surgery. Partial extracorporeal circulation was started, and 5 ml of contrast material was infused from the origin of the aorta. The same parameters as measured in mongrel dogs were analyzed, designating ROls in the inner and outer layrs of the area supplied by the maximally stenosed branch of the coronary artery. Inhalation of Sev caused no change in the PGL,no decrease in the l/O ratio and no significant change in the T1/2. In both the inner and outer ROl, the TTP tended to be prolonged following Sev.inhalation. No patients developed new abnormalities of regional wall motion following Sev inhalation.In both animal and clinical studies, Sev showed no noticeable tendency to induce coronary steal. These results indicate hat sevoflurane can be used safely even in patients with coronary artery disease provided they have no hypotension or other hemodynamic changes. Less

对9只杂种犬进行心肌声学造影(MCE)检查。左冠状动脉内注入5%白蛋白超声溶液2ml。分析了以下参数：(1)经背景校正的峰值灰阶(PGL)；(2)注射至峰值的时间(TTP)；(3)对比度衰减半衰期(T1/2)。在旋支(CX)和左前降支(LAD)供给区的内外层指定感兴趣区(ROL)。给药后，Cx区PGL减少，内、外Cx区PGL比值显著降低(1/0)。Cx区的PGL与LAD区的Pgl之比(Cx/LAD)也明显降低。吸入1MAC七氟醚(SEV)后，L/氧比值明显改善，而CX/LAD比值仍显著降低。使用苯肾上腺素…引起血压升高时E值越高，Cx/LAD比值越高。经食道超声心动图检查9例冠状动脉搭桥术患者的TTP和T1/2无明显变化。开始部分体外循环，从主动脉起始处注入造影剂5ml。分析了与在杂种狗身上测量的相同的参数，指定了冠脉最大狭窄支供血区域的内层和外层的ROL。吸入Sev对PGL无明显影响，对L/O比值无明显影响，对T1/2无明显影响。吸入七次后，内外侧TTP均有延长趋势。在吸入Sev后，没有患者出现新的节段性室壁运动异常。在动物和临床研究中，Sev没有表现出明显的诱发冠状动脉偷窃的趋势。这些结果表明，即使在冠心病患者中使用七氟醚也是安全的，只要他们没有低血压或其他血流动力学变化。较少