氟醚静脉麻醉脊髓血流量的变化.pptVIP

SpinalCordBloodFlowChangebyIntravenousMidazolam

DuringIsofluraneAnesthesia

TomokiNishiyama,MD,PhDByCorallibra

BackgroundMidazolamhasbeenusedforgeneralanesthesiaandsedationduringlocalanesthesiaorartificialventilation.IthasbecomeclearthatmidazolamhasananalgesicpropertymediatedbyGABAreceptorsinthespinalcord.Therefore,itisimportanttoknowtheeffectsofmidazolamonspinalcordbloodflow.

Methods32Cats(male;2.5-3.5Kg;12h)Isoflurane(4%)in100%oxygenIsoflurane(1%)in40%oxygenEnd-tidalcarbondioxidetensionBetween30and40mmHganesthesiamaintainventilation

MethodsMonitor,Mesured5,15,30,60,90,120minmidazolam0,1,2,or4mg/KgHeartrateArterialbloodgasanalysisTemperature37.0℃±0.5℃Midlineskinincision,L1-5wereremoved,andthespinalcordwasexposed.Aplatinumwasinsertedstereotaxicallyintothespinalcordtoadepthof1mmat2mmlateraltothemidlineatL2.Spinalcordbloodflowwasmeasuredeiththehydrogenclearancemethod.Statisticalanalysiswasperformedwithrepeated-measuresanalysisofvariance

ResultsArterialbloodgasvaluesbeforethestudydrugtreatmentwithoutanydifference.Arterialbloodpressuredecreasedduringthefirst30minafterMID2and4mg/KgHeartratedidnotchange.

ResultsSpinalcordbloodflowincreasedsignificantlyfor90minafterMID1mg/Kgandfor15minafterMID2mg/Kg.

Discussion

Discussion

DiscussionHowever,inpatients,midazolamisoftencoadministeredwithotheranestheticsToknowtheeffectsofmidazolam,isofluraneshouldbediscontinued

ConclusionAsmallerdoseofmidazolam(1mg/kg)increasedspinalcordbloodflowwithoutchangesinarterialbloodpressure,butalargerdose(4mg/kg)didnotchangespinalcordbloodflowThiswasassociatedwithasubstantialarterialbloodpressuredecreaseduringisofluraneanesthesia

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