| Japanese |
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| Title | 子宮頸癌根治手術におけるtrimethaphan使用による低血圧麻酔 |
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| Authors | 劒物修*, 仲田房蔵*, 永井一成*, 内沼幸子*, 三好進*, 田中亮*, 林玲子**, 上坊敏子**, 蔵本博行**, 武田秀雄**, 新井正夫** |
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| Authors(kana) | |
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| Organization | *北里大学医学部麻酔科, **北里大学医学部産婦人科 |
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| Journal | 循環制御 |
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| Volume | 5 |
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| Number | 1 |
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| Page | 89-95 |
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| Year/Month | 1984/ |
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| Article | 原著 |
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| Publisher | 日本循環制御研究会 |
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| Abstract | 「要旨」Halothane/N2O麻酔のもとでtrimethaphan使用による低血圧麻酔を子宮頸癌根治術に用い, 手術時間, 術中出血量, 循環動態, 血清カテコラミンなどにつき, 非低血圧麻酔(硬麻/N2O麻酔)と比較検討した. 手術時間の短縮, 術中出血量の減少が低血圧麻酔群で認められた. 収縮血圧を70〜80mmHgに長時間維持しても, 心拍出量は維持され, 尿量も正常範囲に保持され, 特に臓器血流障害と思わせる変化は認められなかった. 血清カテコラミンは上昇せず, 乳酸/ピルビン酸比も増加しなかったことは, 組織の灌流は良く保たれ, 組織での低酸素状態がなかったことを示唆している. Trimethaphanによる血清ヒスタミンの上昇もみられなかった. 低血圧麻酔の特性を理解する麻酔科医のもとで, 適切な症例の選択と術中, 術後の患者管理が十分行われる限り, 本法は安全に施行でき, 手術時間の短縮と術中出血量の減少に貢献できる麻酔法であるとの結論を得た. |
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| Practice | 基礎医学・関連科学 |
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| English |
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| Title | Trimethaphan-induced hypotensive anesthesia for radical operation for uterine cancer |
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| Authors | Osamu Kemmotsu*, Fusazo Nakata*, Kazushige Nagai*, Sachiko Uchinuma*, Susumu Miyoshi*, Ryo Tanaka*, Reiko Hayashi**, Toshiko Jobo**, Hiroyuki Kuramoto**, Hideo Takeda**, Masao Arai** |
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| Authors(kana) | |
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| Organization | *Department of Anesthesiology, Kitasato University School of Medicine, **Department of Gynecology, Kitasato University School of Medicine |
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| Journal | Circulation Control |
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| Volume | 5 |
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| Number | 1 |
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| Page | 89-95 |
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| Year/Month | 1984/ |
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| Article | Original article |
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| Publisher | Japan Society of Circulation Control |
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| Abstract | Whether hypotensive anesthesia could decrease, blood loss related to radical hysterectomy with pelvic lymphadenectomy for cervical cancer was evaluated. The metabolic and hormonal effects of hypotensive anesthesia were also examined. checking plasma catecholamine, blood pyruvate and lactate levels. Sixteen patients were selected for hypotensive anesthesia induced by intravenous drip of 0.2% solution of trimethaphan to decrease systolic blood pressure (SBP) to 70-80 mmHg with halothane/nitrous oxide anesthesia (hypotensive group). In other 17 patients, SBP was maintained above 100 mmHg or 20% decrease of control value under combination of epidural and nitrous oxide anesthesia, and these served as the normotensive group. Intraoperative blood losses (mean ± 1 SEM) were 2658 ± 335ml for the noromotensive group and 900 ± 70ml for the hypotensive group, respectively (p<0.01). Operating time was significantly shortened (p<0.05) in the hypotensive group (291 ± 13min) as compared to the normotensive group (350 ± 16min). |
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| Practice | Basic medicine |
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| Keywords | hypotensive anesthesia, trimethaphan, halothane/nitrous oxide, radical operation of uterine cancer, blood loss, operating time, tissue perfusion, oxygenation |
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