阿片受体、迷走神经和交感神经在瑞芬太尼诱发兔心血管抑制中的作用  

The role of opioid receptors and vagus and sympathetic nerves in remifentaull-induced cardiovascular

作　　者：文益云[1] 徐军美 戴如平[1] 陈恭[2] 

机构地区：[1]中南大学湘雅二医院麻醉科,长沙市410013 [2]中南大学湘雅二医院医务部,长沙市410013

出　　处：《中华麻醉学杂志》2010年第5期539-541,共3页Chinese Journal of Anesthesiology

摘　　要：目的 探讨阿片受体、迷走神经和交感神经在瑞芬太尼诱发兔心血管抑制中的作用.方法 健康新西兰白兔40只,雌雄不拘,2～6月龄,随机分为5组（n=8）,R组静脉注射瑞芬太尼5.0μg/kg;N＋R组静脉注射纳洛酮40μg/,2 min后静脉注射瑞芬太尼5.0μg/kg;V＋R组切断颈部双侧迷走神经后,静脉注射瑞芬太尼5.0 μg/kg;S＋R组行硬膜外穿刺,进行交感神经阻滞后,静脉注射瑞芬太尼5.0 μg/kg;V＋S＋R组切断颈部双侧迷走神经后,进行交感神经阻滞,然后静脉注射瑞芬太尼5.0μg/kg.于注射瑞芬太尼前1 min（T0）、注射后30 s（T1）、1 min（T2）、2 min（T3）、3 min（T4）、4 min（T5）、5 min（T6）、10 min（T7）、15 min（T8）、20 min（T9）时记录HR和MAP.结果 与T0时比较,各组T1时HR均减慢（P＜0.05）;N＋R组各时点MAP差异无统计学意义（P＞0.05）,其余组T1-7时MAP均降低（P＜0.05）;与R组比较,N＋R组T1-7时MAP均升高（P＜0.05）,其余组HR差异无统计学意义（P＞0.05）.结论 瑞芬太尼减慢兔HR的机制与阿片受体、迷走神经和交感神经均无关;而其降低血压的机制与激活阿片受体有关.Objective To investigate the role of opioid receptors and vagus and sympathetic nerves in the remifentanil-induced cardiovascular depression in rabbits. Methods Forty 2-6 months old New Zealand white rebbits of both sexes weighing 1.5-2.5 kg were randomly divided into 5 groups （n = 8 each）： group Ⅰ remifentanil （group R）; group Ⅱ naloxone ＋ remifentanil （group N＋ R）; group Ⅲ vagus nerve cut-off ＋remifentanil （group V＋ R）; group Ⅳ epidural block ＋ remifentanil （group S＋ R） and group V vagus nerve cutoff ＋ epidural block ＋ remifentanil （group V ＋ S ＋ R）. The animals were anesthetized, tracheostomized and mechanically ventilated. PaCO2 was maintained at 35-45 mm Hg. Vecuronium 0.3 mg/kg was given iv every 40 min to keep muscle relaxed. Right carotid artery was cannulated for continuous MAP monitoring. ECG was continuously monitored. A bolus of remifentanil 5.0 μg/kg was administered iv in all 5 groups. In group N ＋ R naloxone 40μg was given iv about 2 min before remifentanil. In group V ＋ R bilateral vagus nerves were cut off through neck incision. After HR and MAP had stabilized for 30 min, remifentanil was given iv. In group S ＋ R epidural block was performed at L6.7 interspace with 2% lidocaine to block cardiac sympathetic nerves. When HR and MAP decreased by 20% of the baseline values and stabilized for 30 min remifentanil was given iv. In group V ＋ S ＋ R bilateral vagus nerves were cut off first. Then epidural block was performed before remifentanil administration. MAP and HR were recorded at 1 min before iv remifentanil administration （T0 ）, at 30 s （T1）, 1,2, 3, 4, 5, 10, 15 and 20 min （T2-9 ） after remifentanil administration. Results Intravenous remifentanil 5.0 μg/kg significantly decreased HR at T1 and MAP at T1-7 as compared with those at T0 in group R. Pretreatmentwith naloxone 40 μg prevented remifentanil-induced decrease in MAP but did not affect remifentanil-induced decrease in HR in group N ＋ R. Vagus nerve cut-off and

关 键 词：哌啶类 受体 阿片样 迷走神经 交感神经系统 心脏功能试验 

分 类 号：R614[医药卫生—麻醉学]