TOTAL INTRAVENOUS ANESTHES IA FOR ORAL AND MAXILLOFACIAL SURGERY - A COMPARI SON BETWEEN NORMOTENSIVE AND HYPERTENSIVE SUBJECTS

家兔脑神经电刺激后，收缩压（SBP）呈现双噬性（先降后升）反应。抑制反应，即三叉神经抑制反应，在低频刺激后表现突出。芬太尼抑制降压药反应，而可乐定、新斯的明和l -苯异丙基腺苷抑制降压反应。在同一时间，可乐定和l -苯异丙腺苷产生剂量依赖性的收缩压降低。鼠脑神经电刺激后收缩压主要表现为加压反应。虽然芬太尼对收缩压变化没有影响，但在家兔实验中，可定抑制了加压反应，并伴有剂量依赖性的收缩压降低。电刺激精神神经超过30秒产生持续的收缩压升高。芬太尼和可乐定可能调节这些收缩压反应。这些结果表明，适当组合这些药物作用于不同部位的伤害机制可能会导致口腔颌面外科手术安全有效的全静脉麻醉。

In rabbits, systolic blood pressure (SBP) showedbiphagic (depressor followedby presjsor) responses following electrical stimulation of the mental nerve. Depressor response, known as the trigeminal depressor response, wasprominent after low frequency stimulations. Fentanyl inhibited depressor response, whereas clonidine, neostigmine and L-phenylisopropyladenosine inhibited pressor response. At t|ie sane time, clonidine and L-phenylisopropyladenosine produced a dose-dependent SBP reduction. In contrast, SBP mainly showed pressor responses following electrical stimulation of the mentalnerve in rats. Although fentanyl revealed no effects on SBP change, clonidine, as in the rabbit experiments, inhibited pressor response along witha dose-dependent SBP reduction.Electrical stimulation of the mental nerve for more than 30 sec produced sustained SBP elevation.Fentanyl and clonidine may modulate these SBP responses.These results suggest that appropriate combinations of these agents that act at different siteof the nociceptive mechanisms may result in safe and effective total intravenous anesthesi for oral and maxillofacial surgery.