| Project/Area Number |
05671267
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| Research Category |
Grant-in-Aid for General Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Research Field |
Anesthesiology/Resuscitation studies
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| Research Institution | Tokushima University |
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Principal Investigator |
KITAHARA Hiroshi Tokushima University, School of Medicine, Instructor, 医学部, 講師 (60161486)
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| Co-Investigator(Kenkyū-buntansha) |
KATO Michihisa Tokushima University, University Hospital Instructor, 医学部・付属病院, 講師 (00214403)
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| Project Period (FY) |
1993 – 1994
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| Project Status |
Completed (Fiscal Year 1994)
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| Budget Amount *help |
¥2,100,000 (Direct Cost: ¥2,100,000)
Fiscal Year 1994: ¥700,000 (Direct Cost: ¥700,000)
Fiscal Year 1993: ¥1,400,000 (Direct Cost: ¥1,400,000)
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| Keywords | Inhalation anesthetic / Myocardial contrast echocardiography / Myocardial ischemia / Coronary steal |
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| Research Abstract |
In 9 mongrel dogs, myocardial contrast echocardiography (MCE) was performed from the heart surface. Sonicated 5% albumin solution (2ml) was infused into the left coronary artery. The following parameters were analyzed : (1) the peak gray level (PGL) corrected for background, (2) the time from injection to the peak (TTP), and (3) the contrast decay half-time (T1/2). Regions of interest (ROls) were designated in the inner and outer layrs of the areas supplied by the circumflex branch (CX) and the left anterior descending branch (LAD). Stensis of CX resulted in areduction of PGL in the CX area and a significant reduction in the ratio of PGL of the inner to that of the outer CX area (1/0 ratio). The ratio of PGL of the CX area to that of the LAD area (CX/LAD ratio) was also decreased significantly. Following inhalation of 1 MAC sevoflurane (Sev), the l/O ratio improved, while the CX/LAD ratio remained significantly reduced. When blood pressure was elevated by administration of phenylephrin
… More
e, the CX/LAD ratio improved. No significant change was observed in the TTP and T1/2.
MCE was performed using transesophageal echocardiography in 9 patients undergoing coronary artery bypass surgery. Partial extracorporeal circulation was started, and 5 ml of contrast material was infused from the origin of the aorta. The same parameters as measured in mongrel dogs were analyzed, designating ROls in the inner and outer layrs of the area supplied by the maximally stenosed branch of the coronary artery. Inhalation of Sev caused no change in the PGL,no decrease in the l/O ratio and no significant change in the T1/2. In both the inner and outer ROl, the TTP tended to be prolonged following Sev.inhalation. No patients developed new abnormalities of regional wall motion following Sev inhalation.
In both animal and clinical studies, Sev showed no noticeable tendency to induce coronary steal. These results indicate hat sevoflurane can be used safely even in patients with coronary artery disease provided they have no hypotension or other hemodynamic changes. Less
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