Effects of dexmedetomidine on cerebral circulation and systemic hemodynamics after cardiopulmonary resuscitation in dogs

被引：13

作者：

Iida H. ^{[1
]}

Iida M. ^{[2
]}

Ohata H. ^{[1
]}

Michino T. ^{[1
]}

Dohi S. ^{[1
]}

机构：

[1] Department of Anesthesiology and Pain Medicine, Gifu University Graduate School of Medicine, Gifu 501-1194

[2] Second Department of Internal Medicine (Cardiology) and Anesthesiology, Faculty of Home Economics, Gifu Women's University, Gifu

来源：

Journal of Anesthesia | 2006年 / 20卷 / 3期

关键词：

Arrhythmia; Cerebral circulation; CPR; Dexmedetomidine;

D O I：

10.1007/s00540-006-0402-0

中图分类号：

学科分类号：

摘要：

Purpose: Our purpose was to examine the effect of dexmedetomidine, when used with phenylephrine during cardiopulmonary resuscitation (CPR), on the cerebral and systemic circulations. Methods: In pentobarbital-anesthetized, mechanically ventilated dogs, we evaluated pial vessel diameters, cerebral oxygen extraction, and systemic hemodynamics before and after cardiac arrest (5min) and resuscitation, in the presence or absence of dexmedetomidine (n = 7 each; dexmedetomidine or control group). Results: In both groups: (a) pial arterioles were dilated at 5 and 15min after CPR, and had returned to baseline diameters at 30min; (b) sagittal sinus pressure was significantly raised at 5 and 15min after CPR; and (c) cerebral oxygen extraction was decreased at 5, 15, and 30min after CPR, and had returned to baseline level at 60min after CPR. We could find no differences between the two groups in the cerebral circulation after CPR. However, the number of defibrillation electric shocks required to restore spontaneous circulation (5.5 vs 3.6; P < 0.05), the dose of phenylephrine used for CPR (1193μg vs 409μg; P < 0.01), and the number of postresuscitation ventricular ectopic beats observed during the first 120min after successful resuscitation (1606 vs 348; P < 0.05) were all significantly lower in the dexmedetomidine group. Conclusion: Although intravenous dexmedetomidine, as used for CPR, does not have a beneficial effect on either cerebral vessels or cerebral oxygen extraction, it may reduce the number of defibrillation shocks needed and the number of postresuscitation ventricular ectopic beats, and help to bring about stable systemic circulation after CPR. © JSA 2006.

引用

页码：202 / 207

页数：5

共 26 条

[1]

McPherson R.W., Koehler R.C., Traystman R.J., Hypoxia, alpha 2-adrenergic, and nitric oxide-dependent interactions on canine cerebral blood flow, Am J Physiol, 266, (1994)

[2]

McPherson R.W., Koehler R.C., Kirsch J.R., Traystman R.J., Intraventricular dexmedetomidine decreases cerebral blood flow during normoxia and hypoxia in dogs, Anesth Analg, 84, pp. 139-147, (1997)

[3]

Ishiyama T., Dohi S., Iida H., Watanabe Y., Shimonaka H., Mechanisms of dexmedetomidine-induced cerebrovascular effects in canine in vivo experiments, Anesth Analg, 81, pp. 1208-1215, (1995)

[4]

Ohata H., Iida H., Dohi S., Watanabe Y., Intravenous dexmedetomidine inhibits cerebrovascular dilation induced by isoflurane and sevoflurane in dogs, Anesth Analg, 89, pp. 370-377, (1999)

[5]

Iida H., Ohata H., Iida M., Watanabe Y., Dohi S., Direct effects of alpha1- and alpha2-adrenergic agonists on spinal and cerebral pial vessels in dogs, Anesthesiology, 91, pp. 479-485, (1999)

[6]

Hayashi Y., Sumikawa K., Maze M., Yamatodani A., Kamibayashi T., Kuro M., Yoshiya I., Dexmedetomidine prevents epinephrine-induced arrhythmias through stimulation of central alpha 2 adrenoceptors in halothane-anesthetized dogs, Anesthesiology, 75, pp. 113-117, (1991)

[7]

Kamibayashi T., Mammoto T., Hayashi Y., Yamatodani A., Takada K., Sasaki S., Yoshiya I., Further characterization of the receptor mechanism involved in the antidysrhythmic effect of dexmedetomidine on halothane/epinephrine dysrhythmias in dogs, Anesthesiology, 83, pp. 1082-1089, (1995)

[8]

Kamibayashi T., Hayashi Y., Mammoto T., Yamatodani A., Sumikawa K., Yoshiya I., Role of the vagus nerve in the antidysrhythmic effect of dexmedetomidine on halothane/epinephrine dysrhythmias in dogs, Anesthesiology, 83, pp. 992-999, (1995)

[9]

Traystman R.J., Fitzgerald R.S., Loscutoff S.C., Cerebral circulatory responses to arterial hypoxia in normal and chemodenervated dogs, Circ Res, 42, pp. 649-657, (1978)

[10]

Hoffman W.E., Kochs E., Werner C., Thomas C., Albrecht R.F., Dexmedetomidine improves neurologic outcome from incomplete ischemia in the rat. Reversal by the alpha 2-adrenergic antagonist atipamezole, Anesthesiology, 75, pp. 328-332, (1991)

← 1 2 3 →