A QUESTFOR BETTER GENERALANESTHESIA TARGETING HEMODYNAMICSTABILITY FOR ORAL SURGEI

寻求更好的全身麻醉，以口腔手术的血流动力学稳定性为目标

• 批准号: 07672189
• 负责人: ICHINOHE Tatsuya
• 金额: $ 1.54万
• 依托单位: TOKYO DENTAL COLLEGE
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 1995
• 资助国家: 日本
• 起止时间: 1995 至 1997
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-07672189/
• 关键词: Noxious stimulation; Hemodynamic response; Nitrous oxide; Isoflurane; Fentanyl; Clonidine; Neostigmine; L-phenylisopropyladenosine; ペンタゾシン; プロポフォール; ケタミン; trigeminal depressor response; エピネフリン; 大脳皮質組織血流量; 大脳皮質組織酸素分圧

Systolic blood pressure (SBP) showed biphagic (depressor followed by pressor) responses following electrical stimulation of the mental nerve in rabbits. Depressor response, known as the trigeminal depressor response, was prominent after low frequency stimulations. Changes in cerebral cortex regional blood flow (rCBF) and tissue oxygen tension during the TDR was similar to those during electrical vagal nerve stimulation.Nitrous oxide ameliorated this rCBF reduction.Isoflurane at 1.5 minimum alveolar concentration with or without nitrous oxide inhibited these depressor and pressor responses at the cost of normotension. Fentanyl inhibited depressor response, whereas clonidine, neostigmine and L-phenylisopropyladenosine inhibited pressor response. Clonidine and L-phenylisopropyladenosine produced dose-dependent SBP reduction. Pentazocine, in contrast to fentanyl, inhibited pressor response. Propofol and ketamine also inhibited pressor response. These results suggest that appropriate combinations of these drugs which act at different site of the nociceptive mechanisms may result in safe and effective anesthesia for oral surgery.

电刺激兔的精神神经后，其收缩压(SBP)呈现先降后降的双相反应。降压反应，称为三叉神经降压反应，在低频刺激后显著。TDR期间大脑皮层局部血流量(RCBF)和组织氧分压的变化类似于迷走神经电刺激时的变化，一氧化二氮可以改善这种rCBF的减少，在有或没有一氧化二氮的情况下，1.5最低肺泡浓度的异氟醚以正常血压为代价抑制了这些降压和升压反应。芬太尼抑制升压反应，可乐定、新斯的明和L苯异丙基腺苷抑制升压反应。可乐定和L-苯异丙基腺苷可剂量依赖性地降低血压。与芬太尼不同，五唑西汀抑制升压反应。异丙酚和氯胺酮也抑制升压反应。这些结果表明，这些药物作用于伤害性机制的不同部位的适当组合可能会导致口腔手术安全有效的麻醉。

项目成果

一戸達也ら: "兎の口腔領域侵害刺激に対する循環応答とネオスチグミンの応答抑制効果" 日歯麻誌. 25. 606 (1997)

Tatsuya Ichinohe 等人：“兔子口腔区域对有害刺激的循环反应和新斯的明的反应抑制作用”日本牙科医学杂志 25. 606 (1997)。

一戸達也ら: "兎オトガイ神経電気刺激児にL-phenyl isopropy ladenosineの効果" J Anesth. 12. (1998)

Tatsuya Ichinohe 等人：“L-苯基异丙基拉腺苷对电刺激儿童精神神经的影响”J Anesth 12。（1998）

Ichinohe T et al.: "The effects of nitrous oxide and isoflurane on the somatosympathetic reflxes during electrical stimulation of the mental nerve in rabbits" Anesth Analg. 84. S498 (1997)

Ichinohe T 等人：“一氧化二氮和异氟烷对兔子精神神经电刺激期间躯体交感神经反射的影响”Anesth Analg。

一戸達也ら: "兎の口腔領域侵害刺激に対する循環応答と笑気およびイソフルランの応答抑制効果" 日本歯科麻酔学会雑誌. 24(4). 743- (1996)

Tatsuya Ichinohe 等人：“兔子口腔区域对有害刺激的循环反应以及笑气和异氟烷的反应抑制作用”日本牙科麻醉学会杂志 24(4)。

一戸達也: "Trigeminal depressor response, 迷走神経刺激およびATP静注による血圧低下時の循環動態の比較" Journal of Anesthesia. 10suppl. 337- (1996)

Tatsuya Ichinohe：“三叉神经降压反应，通过迷走神经刺激和静脉 ATP 注射降低血压期间的血流动力学比较”，麻醉杂志 10suppl。