The Effects of Inhalation Anesthetics in Regional Myocardial Blood Distribution.

对9只杂种犬进行心脏表面超声心动图（MCE）检查。超声检测5%白蛋白溶液2ml注入左冠状动脉。分析了以下参数：(1)校正背景的峰值灰度（PGL），(2)从注入到峰值的时间（TTP），(3)对比度衰减半衰期（T1/2）。在旋转支（CX）和左前降支（LAD）供应的区域的内层和外层指定感兴趣区域（ROls）。CX狭窄导致CX区PGL减少，CX内、外区PGL比值显著降低（1/0）。CX区PGL与LAD区PGL之比（CX/LAD ratio）也显著降低。吸入1 MAC七氟醚（Sev）后，l/O比有所改善，而CX/LAD比仍显著降低。当给药苯肾上腺素升高血压时，CX/LAD比值改善。TTP和T1/2无明显变化。采用经食管超声心动图对9例行冠状动脉搭桥术的患者进行MCE检查。开始部分体外循环，从主动脉起始处灌注造影剂5ml。分析了在杂种狗中测量的相同参数，指定冠状动脉最大狭窄分支供应区域的内层和外层的rol。吸入Sev未引起PGL变化，l/O比值未降低，T1/2无明显变化。在内、外ROl中，吸入sev后TTP均有延长的趋势。无患者在吸入Sev后出现新的局部壁运动异常。在动物和临床研究中，Sev均未表现出明显的诱发冠状动脉心肌梗死的倾向。这些结果表明，七氟醚甚至可以安全地用于冠心病患者，只要他们没有低血压或其他血流动力学改变。少

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