STUDY ON THE CHANGE OF INTRACARDIAC CONDUCTION SYSTEM AND ITS MECHANISM DURING EPIDURAL ANALGESIA

硬膜外镇痛过程中心内传导系统变化及其机制研究

• 批准号: 07671679
• 负责人: NISHIKAWA Kiyonobu
• 金额: $ 1.54万
• 依托单位: OSKA CITY UNIVERSITY
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 1995
• 资助国家: 日本
• 起止时间: 1995 至 1997
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-07671679/
• 关键词: EPIDURAL OPIOIDS; ALPHA2-AGONISTS; CARDIAC SYMPATHETIC NERVE ACTIVITY; INTRACARDIAC CONDUCTION; α_2・アゴニスト; プロポフォール

The effects of epidural analgesia with opioids and clonidine, one of the alpha-2 agonists, during general anesthesia on cardiac and renal sympathetic nerve activity and intracardiac conduction were studied in the cats. Thoracic epidural administration of morphine during alpha-chloralose anesthesia dramatically decreased sympathetic nerve activity and attenuated sinus nodal and AV nodal functions. Alomost the same effects were observed with epidural morphine in the cat baroreceptor nerves and vagal nerves were sectioned. Lumbar epidural administration of morphine has shown the same effect as thoracic epidural administration, so epidural morphine was supposed to spread extensively in CSF and act not only on spinal cord but also brainstem. This was probably due to the hydrophilic property of morphine. Epidural fentanyl or meperidine also depressed sympathetic nerve activity and intracardiac conduction, however showed a segmental depression of sympathetic activity. These depressions with meperidine were only partially reversed with intravenous naloxon.Epidural clonidine, one of the alpha-2 agonists, also showed decrease in sympathetic nerve activity and attenuation of sinus nodal and AV nodal functions. The dose effect of epidural clonidine was not linear, which was maximal at 4 microgram/kg.

在全身麻醉期间，在猫中研究了硬膜外镇痛与α-2激动剂之一的阿片类药物和可乐定的作用，对心脏和肾交感神经活性和心脏内传导的影响。在α-氯拉萨麻醉期间，胸甲硬膜外施用大幅度降低了交感神经活性，并减弱了窦性鼻腔和AV淋巴结功能。 Alomost在猫压力感受器神经和迷走神经中观察到硬膜外吗啡的相同作用。吗啡的腰椎硬膜外给药表现出与胸硬膜外给药相同的作用，因此硬膜外吗啡被认为在CSF中广泛扩散，不仅在脊髓上，而且在脑干上作用。这可能是由于吗啡的亲水性。硬膜外芬太尼或梅皮丁还抑制交感神经活性和心脏内传导，但显示出分段的交感神经活性抑郁症。这些与甲状腺素的凹陷仅通过静脉内纳洛克酮部分逆转。静脉内可乐定（α-2激动剂之一）也显示出交感神经活性和鼻窦结节和AV节结节功能的衰减的降低。硬膜外可乐定的剂量作用不是线性的，它在4微克/kg时最大。

项目成果

Mitsuhide Yabe, Kiyonobu Nishikawa, Takekazu Terai, Hidekazu Yukioka, Mitsugu Fujimori: "The effects of intrinsic nitric oxide on cardiac neural regulation in cats." Anesth Analg. 86(6). 1194-1200 (1998)

Mitsuhide Yabe、Kiyonobu Nishikawa、Takekazu Terai、Hidekazu Yukioka、Mitsugu Fujimori：“内在一氧化氮对猫心脏神经调节的影响。”

Osamu Morimoto, et, al.: "Effects of intravenous mapivanaim on renal sympathethe narve activity in the cat during nitrous oxide and nitrous oxide-harothane anesthesia" Reg Anesth. 21. 41-48 (1996)

Osamu Morimoto 等人：“一氧化二氮和一氧化二氮-哈罗坦麻醉期间静脉注射马匹瓦那姆对猫肾交感神经神经活动的影响”Reg Anesth。

Takashi Mori, Kiyonobu Nishikawa, Takekazu Terai, Hidekazu Yukioka, Akira Asada: "The effects of epidural morphine on cardiac and renal sympathetic nerve activity in alpha-chloralose-anesthetized cats." Anesthesiology. 88(6). 1558-65 (1998)

Takashi Mori、Kiyonobu Nishikawa、Takekazu Terai、Hidekazu Yukioka、Akira Asada：“硬膜外吗啡对 α-氯醛糖麻醉猫心脏和肾脏交感神经活动的影响。”

Takashi Mori,Kiyonobu Nishikawa,Takekazu Terai,Hidekazu Yukioka,Akira Asada: "The effects of opidural morphzne on cardiac and nenal sympathetic nerve activity in α-chloralose-anesthetized cats" Aneathesiology. (印刷中).

Takashi Mori、Kiyonobu Nishikawa、Takekazu Terai、Hidekazu Yukioka、Akira Asada：“硬膜外吗啡对 α-氯醛糖麻醉猫心脏和肾交感神经活动的影响”麻醉学（正在出版）。

Kiyonobu Nishikawa, Mitsuhide Yabe, Takekazu Terai, Hidekazu Yukioka, Mitsugu Fujimori: "The effects of dobutamine and phenilephsine an atrieventrieular conduction during combined use of halothane and thoracic epidural lidocaine" Anesthesia and Analgesia.

Kiyonobu Nishikawa、Mitsuhide Yabe、Takekazu Terai、Hidekazu Yukioka、Mitsugu Fujimori：“氟烷和胸段硬膜外利多卡因联合使用时多巴酚丁胺和苯尼菲辛对心房传导的影响”麻醉和镇痛。