| Japanese |
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| Title | 広汎子宮全摘術に対するイソフルレンによる低血圧麻酔 |
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| Authors | 水嶋雅子*, 劔物修*, 横田祥*, 今井真*, 合田由起子*, 佐々木和郎*, 牧野田知**, 藤本征一郎**, 一戸喜兵衛** |
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| Authors(kana) | |
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| Organization | *北海道大学医学部麻酔学教室, **北海道大学医学部産婦人科教室 |
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| Journal | 循環制御 |
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| Volume | 8 |
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| Number | 3 |
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| Page | 385-391 |
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| Year/Month | 1987/ |
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| Article | 原著 |
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| Publisher | 日本循環制御医学会 |
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| Abstract | 広汎子宮全摘術にイソフルレン単独による低血圧麻酔を施行し, 循環動態, 血清カテコラミンなどに及ぼす影響について検討した. 収縮期血圧を80mmHg程度に調節することは容易であり, 低血圧を長時間維持しても, 心係数は正常に保持され, 重要臓器の血流を阻害する所見は認められなかった. 血清カテコラミンは正常範囲内にあった. 2MAC以上のイソフルレンの長時間吸入でも麻酔の覚醒は良好であり, 術後の肝・腎機能検査によっても特に異常は認めなかった. イソフルレン単独による低血圧麻酔は, 吸入濃度を注意深く調節すれば安全に施行できる. |
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| Practice | 基礎医学・関連科学 |
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| English |
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| Title | Clinical evaluation of induced hypotension by isoflurane anesthesia in radical operation of uterine cancer |
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| Authors | Masako Mizushima*, Osamu Kemmotsu*, Sho Yokota*, Makoto Imai*, Yukiko Goda*, Kazuo Sasaki*, Satoru Makinoda**, Seiichiro Fujimoto**, Kihyoe Ichinoe** |
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| Authors(kana) | |
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| Organization | *Department of Anesthesiology, Hokkaido University School of Medicine, **Department of Gynecology, Hokkaido University School of Medicine |
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| Journal | Circulation Control |
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| Volume | 8 |
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| Number | 3 |
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| Page | 385-391 |
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| Year/Month | 1987/ |
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| Article | Original article |
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| Publisher | Japan Society of Circulation Control |
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| Abstract | Although isoflurane is a potent inhalation anesthetic, cardiac depressant effects of this agent are less than those of halothane or enflurame. With higher concentrations the direct vasodilator effects of isoflurane predominate. Induced hypotension by isoflurane anesthesia was produced in 11 patients undergoing radical hysterectomy and pelvic lymphadenectomy for uterine cancer. Cardiovascular functions together with plasma catecholamine levels and renin activity were measured before, during and after induced hypotension with isoflurane anesthesia. Both renal and liver functions were followed for 14 days postoperatively. Operative blood loss and operating time of induced hypotension were compared with those by normotensive anesthesia with enflurane／nitrous oxide in 10 patients. Systolic blood pressure was controlled to about 80mmHg under isoflurane and nitrous oxide anesthesia（2.2 MAC）. Blood pressure was smoothly reduced, while cardiac output remained near prehypotensive value. Heart rate was not changed during the hypotensive state. Plasma catecholamine levels and renin activity were not increased by induced hypotension. Recovery from anesthesia was smooth and uneventful, and no major complications were observed related to induced hypotension. Operative blood loss was reduced to about half of that by normotensive anesthesia under enflurane／nitrous oxide anesthesia Operating time was also significantly shortened by hypotensive anesthesia. Postoperative liver and renal function tests revealed no significant changes A reduction in cardiac output during hypotensive anesthesia is not ideal since maintenance of cardiac output is crucial for blood flow to vital organs in order to maintain a sufficient supply of oxygen and energy substractes. In our study, isoflurane did not produce reduction of cardiac output during hypotensive anesthesia. We conclude that isoflurane can be employed safely and effectively as a hypotensive agent. |
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| Practice | Basic medicine |
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| Keywords | induced hypotension, isoflurane, radical operation of uterine cancer |
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