このエントリーをはてなブックマークに追加
ID 15988
Eprint ID
15988
フルテキストURL
Thumnail 99_1017.pdf 676 KB
タイトル(別表記)
Effects of isoflurane anesthesia on circulation dynamics and blood catecholamine concentrations
著者
坂野 成宏 岡山大学医学部麻酔・蘇生学教室
抄録
In the present study, dogs were administered isoflurane at 3 concentrations, 1.5%, 2.2% and 3%, for 135 min. The end-tidal concentrations and blood concentrations of isoflurane were determined, and the relation between circulation dynamics and blood catecholamine concentrations was examined. In addition, the effect of a pain stimulation, given 120 min. after starting the inhalation, on the circulation dynamics and blood catecholamine concentrations was investigated. From 30 min. after the inhalation was begun, the anesthetic depth was maintained at 1MAC, 1.5MAC and 2MAC at the isoflurane inhalation concentrations of 1.5%, 2.2% and 3%, respectively. The blood isoflurane concentrations changed proportionally with the end-tidal concentrations: 9.8 mg/dl at 1MAC, 14.8 mg/dl at 1.5MAC and 19.0 mg/dl at 2MAC. The correlations between the blood isoflurane concentrations during inhalation and several parameters of circulatory dynamics were highly negative. The correlation coefficients were γ=-0.888 (mean arterial pressure), γ=-0.726 (heart rate), γ=-0.743 (cardiac index) and γ=-0.855 (left ventricular peak dp/dt/IP). On the other hand, the correlation between the blood isoflurane concentrations and the systemic vascular resistance was low (γ=-0.515). Highly negative correlations were found between the blood isoflurane concentrations during inhalation and the blood catecholamine concentrations: adrenaline, γ=-0.864; noradrenaline, γ=-0.687. The results of the present study indicate that isoflurane suppresses the circulatory dynamics, and that this suppression is due in part to the suppression of the sympathetic nervous system and adrenal system, as indicated by the blood catecholamine levels. However, while the catecholamine levels recovered after termination of the inhalation, none of the parameters of circulatory dynamics returned to pre-inhalation levels except the mean arterial pressure. The recovery of the heart rate, cardiac index and left ventricular peak dp/dt/IP was poor, indicating that myocardial suppression due to isoflurane continued even after anethesia was discontinued. The pain stimulation given 120 min into the inhalation period did not lead to any significant changes in the circulatory dynamics in any group, but it did cause a significant rise in the blood catecholamine concentration in the 1.5% (1MAC) group. This result indicates that the 1MAC isoflurane anethesia is not deep enough to block the centripetal impulse resulting from the stimulation.
キーワード
終末呼気中イソフルレン濃度
血中イソフルレン濃度
血中アドレナリン濃度
血中ノルアドレナリン濃度
循環動態
発行日
1987-08-30
出版物タイトル
岡山医学会雑誌
出版物タイトル(別表記)
Journal of Okayama Medical Association
99巻
7-8号
出版者
岡山医学会
出版者(別表記)
Okayama Medical Association
開始ページ
1017
終了ページ
1029
ISSN
0030-1558
NCID
AN00032489
資料タイプ
学術雑誌論文
オフィシャル URL
https://www.jstage.jst.go.jp/article/joma1947/99/7-8/99_7-8_1017/_article/-char/ja/
関連URL
http://www.okayama-u.ac.jp/user/oma/index.html
言語
Japanese
著作権者
岡山医学会
論文のバージョン
publisher
査読
有り
Eprints Journal Name
joma