A QUESTFOR BETTER GENERALANESTHESIA TARGETING HEMODYNAMICSTABILITY FOR ORAL SURGEI

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。

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.