异丙酚、咪唑安定、依托咪酯及同芬太尼复合后对大鼠心肌细胞钙离子移动的影响

Effects of Propofol,Midazolam,Etomidate and Their Combination with Fentanyl on Intracellular Ca^( 2+) Mobilization in Isolated Rat Ventricular Myocytes

的 观察麻醉诱导峰浓度的异丙酚、咪唑安定、依托咪酯及同芬太尼复合后,对心肌细胞钙离子移动的影响,研究其对心肌收缩力的作用。方法 用Fluo-3AM钙荧光指示剂染色急性分离的大鼠心肌细胞,在激光共聚焦显微镜下动态观察用药前和使用异丙酚(50μmol/L)、咪唑安定(3μmol/L)、依托咪酯(3μmol/L)及复合芬太尼(20ng/ml)后,KCl诱发的细胞内钙离子荧光强度的变化。结果 异丙酚明显抑制钙离子跨膜内流,细胞内钙荧光强度峰值较对照组下降15.3%(P<0.05),而咪唑安定、依托咪酯虽减慢钙的内流,但最终细胞内钙荧光强度与对照组无统计学差异(P>0.05)。复合芬太尼后,各组细胞内钙荧光强度升高的速度和峰值较单独使用该静脉麻醉药无统计学差异(P>0.05)。结论 复合使用芬太尼不会加重异丙酚、咪唑安定。

To investigate the effects of propofol,midazolam,etomidate and their combination with fentanyl on intracellular Ca 2+ mobilization in rat ventricular myocytes. Methods Freshly isolated rat ventricular myocytes were loaded with Fluo-3AM,a Fluorescent Ca 2+ indicator.The effects of propofol (50 μmol/L), midazolam (3 μmol/L),etomidate (3 μmol/L) and their combination with fentanyl (20 ng/ml) on changes of intracellular Ca 2+ concentration induced by KCl were investigated. Results Propofol inhibited Ca 2+ transsarcolemmal influx remarkably, the peak intracellular Ca 2+ concentration decreased about 15.3 % ( P <0.05).Though midazolam and etomidate slowed Ca 2+ influx,the eventual peak concentration of intracellular Ca 2+ had no statistical difference from that of the control group.There was no significant difference in the peak concentration of intracellular Ca 2+ and the velocity of Ca 2+ influx in the groups using propofol,midazolam,or etomidate,in combination with fentanyl as compared with the groups using the same intravenous anesthetics alone ( P >0.05). Results Propofol inhibited Ca 2+ transsarcolemmal influx remarkably, the peak intracellular Ca 2+ concentration decreased about 15.3 % ( P <0.05).Though midazolam and etomidate slowed Ca 2+ influx,the eventual peak concentration of intracellular Ca 2+ had no statistical difference from that of the control group.There was no significant difference in the peak concentration of intracellular Ca 2+ and the velocity of Ca 2+ influx in the groups using propofol,midazolam,or etomidate,in combination with fentanyl as compared with the groups using the same intravenous anesthetics alone ( P >0.05). Conclusions The negative inotropic effects of propofol,midazolam,and etomidate,which are mediated by inhibiting Ca 2+ transsarcolemmal influx,will not be worsened by their combined use with fentanyl.