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Title:: Influence of propofol on cardiovascular center during general anesthesia

作者:: 劳宁¹; 徐礼鲜²; 聂煌³; 范莹盈²; 张惠²; 第四军医大学：1.西京医院麻醉科，2.口腔医院麻醉科，陕西西安 710032，

Author(s):: LAO Ning¹; XU LiXian²; NIE Huang³; FAN YingYing²; ZHANG Hui²; 1.Department of Anesthesiology, Xijing Hospital,2.Department of Anesthesiology, Qindu Stomatological Hospital, Fourth Military Medical University,Xi’an 710032,Shaanxi, China;3.Department of Anesthesiology,General Hospital,Guangzhou Military Area,Guangzhou 510010,Guangdong,China

关键词:: 异丙酚; 循环抑制; 全身麻醉

Keywords:: propofol; circulatory depression; general anesthesia

分类号:: R614.24

DOI:: -

文献标识码:: A

摘要:: 目的探讨异丙酚的循环抑制作用是以中枢抑或外周抑制为主。方法将8只犬先后通过颈内动脉输注［速率为0.2 mg/(kg·min)或股静脉速率为2 mg/(kg·min)输注］异丙酚进行麻醉。当听觉诱发电位指数（AAI）达AAIhypnotic时，停止输注，即刻测定血清、脑脊液中药物的浓度；记录麻醉过程中每min血压、心率的变化。结果颈内动脉麻醉（IA）组中，各时间点的血压均显著高于静脉麻醉（IV）组（P<0.05或P<0.01）；但心率明显低于IV组（P<0.05或P<0.01）。IA组的血压与诱导前相比无显著差异；而IV组较诱导前显著下降（P<0.01），达到AAIhypnotic时，IV组血清异丙酚的浓度显著高于IA组（P<0.01），但两组的脑脊液中异丙酚的浓度相比无显著差异。结论当脑内异丙酚的浓度达麻醉水平而外周血清中异丙酚的浓度较低时，异丙酚的循环抑制作用不明显，提示中枢机制在异丙酚的循环抑制作用中不占主要地位。

Abstract:: AIM To explore whether the central or the peripheral mechanism is dominant in circulatory depression induced by propofol. METHODS Eight mongrel dogs received intracarotid or intravenous (femoral vein) infusion of propofol at the rate of 0.2 mg/(kg·min) intracarotid or 2 mg/(kg·min) intravenous respectively. Infusion was stopped at the point when the auditory evoked potential index reached the predetermined AAIhypnotic and propofol concentrations of plasma and cerebral spinal fluid were measured. Blood pressure and heart rates were recorded continuously during anesthesia. RESULTS Blood pressure (BP) was higher during intracarotid anesthesia than that in intravenous anesthesia, whereas heart rates in intracarotid (IA) group were slower compared with those in intravenous (IV) group. BP decreased obviously in IV group and no difference was observed in IA group compared with preinduction. Propofol concentration of plasma in IV group was higher than that in IA group when AAI reached AAIhypnotic, however there was no difference in concentration of cerebral spinal fluid between the two groups at that moment. CONCLUSION Circulatory depression is not obvious at the hypnotic concentration in brain with low concentration in plasma, which indicates that central effect contributes less to the hypotension than the peripheral effect in propofol anesthesia.

参考文献/References

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全身麻醉中异丙酚对循环抑制作用机制的研究(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

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