THE EFFECT OF ANESTHETICS ON CARDIO-VASCULAR INTERACTION

麻醉药对心血管相互作用的影响

• 批准号: 05671269
• 负责人: HOKA Sumio
• 金额: $ 1.34万
• 依托单位: KYUSHU 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-05671269/
• 关键词: isoflurane; halothane; myocardial contractility; ventriculo-arterial coupling; Ea; Ees; 麻酔薬; 心収縮性; 心室圧容量関係; イソフルレン; ハロセン; α作用; 血管抵抗; alpha作用; 後負荷; 仕事効率

We compared the effects of two volatile anesthetics, halothane and isoflurane, on ventriculo-arterial coupling using an index of Ea/Ees. Ea and Ees represent arterial effective elastance and left ventricular end-systolic elastance, and are used as indices of cardiac afterload and cardiac contractility, respectively. Halothane 2MAC significantly decreased the cardiac output, Ea, and Ees by 35%, 18%, and 39%, respectively. Isoflurane 2MAC significantly decreased the cardiac output, Ea, and Ees by 37%, 38%, and 43%, respectively. Halothane increased Ea/Ees from 0.83 to 1.22, whereas isoflurane maintained the Ees/Es at a constant level. These results suggest that mechanical efficiency is well maintained during isoflurane anesthesia because it has an equivalent effect on left ventricular contractility and arterial properties, whereas halothane can impair mechanical efficiency by depressing left ventricular contractility more than the arterial system.Our results also suggest that al-adrenoceptor stimulation is capable of reversing direct cardiac depressant effects of halothane, and that al-adrenoceptor stimulation may also be accompanied by a possible impairment of the oxygen supply-demand balance during halothane anesthesia.

我们使用EA/EES指数比较了氟烷和异氟醚两种挥发性麻醉剂对脑室-动脉偶联的影响。Ea和Ees代表动脉有效弹性和左心室收缩末期弹性，分别作为心脏后负荷和心脏收缩能力的指标。氟烷2MAC可使心输出量、Ea和EES分别降低35%、18%和39%。异氟醚2MAC使心输出量、Ea和EES分别降低37%、38%和43%。氟烷使Ea/Ees从0.83增加到1.22，而异氟烷使Ee/Es保持不变。这些结果表明，在异氟醚麻醉过程中，机械效率得到很好的维持，因为它对左心室收缩和动脉特性有同等的影响，而氟烷可以通过抑制左心室收缩能力而不是动脉系统来损害机械效率。我们的结果还表明，刺激al-肾上腺素受体能够逆转氟烷的直接心脏抑制作用，并且al-受体刺激也可能伴随着氟烷麻醉期间氧供需平衡的损害。

项目成果

外 須美夫: "心臓血管相互作用と麻酔." 麻酔. 44. S52-S58 (1995)

Sumio Soto：“心血管相互作用和麻醉。”44. S52-S58 (1995)

Hoka, S., Kawasaki, T., Okamoto, H., Okuyama, T., Takahashi, S.: "Effects of phenylephrine and prostaglandin E1 on ventriculo-arterial matching during halothane anaesthesia" Br.J.Anaesth.74. 438-442 (1995)

Hoka，S.，川崎，T.，冈本，H.，奥山，T.，高桥，S.：“氟烷麻醉期间去氧肾上腺素和前列腺素 E1 对心室动脉匹配的影响”Br.J.Anaesth.74。

Okuyama T.et al.: "Alphal-adrenoceptor stimulation is able to reverse halothane-induced cardiac depression in isolated rat hearts." Acta Anaesth.Scand.41. 939-944 (1997)

Okuyama T.等人：“α-肾上腺素受体刺激能够逆转氟烷引起的离体大鼠心脏抑制。”

外 須美夫: "心室-血管系の相互関係に及ぼすPGEの影響" 現代医療. 25. 3861-3868 (1993)

Sumio Soto：“PGE 对心室-血管系统相互作用的影响”现代医学 25. 3861-3868 (1993)。

Kawasaki T.et al.: "The difference of isoflurane and halothane in ventriculo-arterial coupling in dogs." Anesth.Analg.79. 681-686 (1994)

Kawasaki T.et al.：“异氟烷和氟烷在狗心室-动脉耦合方面的差异。”