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عمومی::
اثر متسعکنندگی عروق (اثر وازودیلاتوری)
Isoflurane, desflurane, and sevoflurane may have a modest cerebral vasodilating effect in the human cortex when administered at doses of 1 MAC or less.
The net vasodilating effects of equi-MAC concentra- tions of isoflurane, desflurane, and sevoflurane are less in humans than that of halothane, and the former are prob- ably therefore preferable if a volatile anesthetic is to be used in the setting of impaired intracranial compliance.
In most investigations, including several in humans, dur- ing which N2O has been added to a volatile anesthetic of 1 MAC or greater, substantial increases in CBF have been recorded.179,180 A comparison of an approximately equi- MAC substitution of N2O for isoflurane revealed that CBF was greater by 43% with 0.75 MAC isoflurane and 65% N2O in comparison to 1.5 MAC isoflurane.181 Several inves- tigations have confirmed that CBF will be less with 1 MAC isoflurane than with a 1 MAC combination achieved with 50% to 65% N2O and isoflurane.179,181,182 These observa- tions are consistent with a substantial additive vasodilating effect of N2O in the presence of a volatile agent.
This vasodilating effect of N2O may be positively cor- related with the concentration of inhaled drug180 and
During a period of focal ischemia, the vasodilating effect of NO (probably constitutively elaborated NO of endo- thelial origin) probably serves to augment collateral CBF.
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