| Japanese |
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| Title | Prostaglandin E1(PGE1)による人為的低血圧麻酔の臨床的検討 |
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| Subtitle | 原著 |
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| Authors | 岡村篤*1, 堂崎信一*1, 劔物修*1, 山村剛康*1, 久保田宗宏*2, 佐々木和郎*3, 北条泰*4, 中尾康夫*5, 福田正人*6, 斉藤芳儀*7, 塩谷勉*8, 大久保敏博*9, 菊地秀樹*10 |
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| Authors(kana) | |
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| Organization | *1北海道大学医学部麻酔学教室, *2市立札幌病院麻酔科, *3国立札幌病院麻酔科, *4札幌厚生病院麻酔科, *5美唄労災病院麻酔科, *6砂川市立病院麻酔科, *7旭川厚生病院麻酔科, *8函館中央病院麻酔科, *9釧路労災病院麻酔科, *10市立稚内病院麻酔科 |
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| Journal | 循環制御 |
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| Volume | 11 |
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| Number | 2 |
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| Page | 239-244 |
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| Year/Month | 1990/ |
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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 | 「要旨」プロスタグランディンE1(PGE1)は, 血圧降下作用とともに脳, 冠動脈, 肝, 腎などの重要臓器の血流を維持することから, 術中の異常高血圧や低血圧麻酔に適用される機会が増えてきている. PGE1による低血圧麻酔を多施設において, 正常血圧患者138例と高血圧患者39例に適用し, 血圧の調節性, 心機能および腎機能に与える影響を比較検討し, 特に高血圧症例における有用性および安全性を検討した. 手術時間, 麻酔時間, PGE1投与速度, 総投与量, 投与時間に差はなく, 目的とする血圧に到達する時間と血圧が回復するのに要した時間にも差異はなかった. 心拍数は正常血圧群で増加したが, 臨床的に許容範囲内であり, 高血圧群では有意な変化はなかった. 両群において肺動脈楔重圧は低下傾向を示し, 心係数は有意な上昇を示した. 心電図上でST変化などの虚血性変化は出現しなかった. 尿量係数｛尿量/(輸液量+輸血量-出血量)｝は両群ともよく保たれた. 高血圧患者においても, PGE1は血圧の調節性は正常血圧患者と差がなく, 心機能を改善し, 腎機能を障害せず, 安全に臨床使用が可能な事が判明した. また一般に高血圧患者は全身の動脈硬化が存在することが多く, 重要臓器の血流を維持するという観点からも, PGE1による低血圧麻酔によい適応症例であると思われた. |
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| Practice | 基礎医学・関連科学 |
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| Keywords | Prostaglandin E1, induced hypotenison, hypertensive patients, normotensive patients, hemodynamics |
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| English |
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| Title | Induced hypotension by an infusion of Prostaglandin E1 in normotensive and hypertensive patients |
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| Subtitle | |
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| Authors | Atsushi Okamura*1, Shinichi Dozaki*1, Osamu Kemmotsu*1, Takeyasu Yamamura*1, Munehiro Kubota*2, Kazuo Sasaki*3, Yasushi Hojyo*4, Yasuo Nakao*5, Masato Fukuda*6, Yoshinori Saito*7, Tsutomu Enya*8, Toshihiro Okubo*9, Hideki Kikuchi*10 |
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| Authors(kana) | |
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| Organization | *1Department of Anesthesiology Hokkaido University School of Medicine, *2Sapporo City Hospital, *3Sapporo National Hospital, *4Sapporo Public Welfare Hospital, *5Bibai Rosai Hospital, *6Sunagawa City Hospital, *7Asahikawa Public Welfare Hospital, *8Hakodate Central Hospital, *9Kushiro Rosai Hospital, *10Wakkanai City Hospital |
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| Journal | Circulation Control |
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| Volume | 11 |
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| Number | 2 |
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| Page | 239-244 |
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| Year/Month | 1990/ |
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| Article | Original article |
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| Publisher | Japan Society of Circulation Control |
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| Abstract | Hypotensive anethesia is applied in cases in which massive bleeding is anticipated. The purpose of this modality is to reduce total amount of bleeding and make the operating fields dry and avoid complications of transfusion. We examined the availability of prostaglandin E1 (PGE1) for the induced hypotension in hypertensive patients comparing with normotensive patients. Patients are divided into two groups, 138 normotensive patients (group A) and 39 hypertensive patients (group B). There were no significant differences in the time to reach the aimed hypotensive state and in the time to recovery to the control state between groups A and B. Cardiac index was increased in both groups. Urine output maintained over 100 ml/hr and urine index (urine output/ (infusion + transfusion - blood loss)) was not decreased. Because PGE1 maintains cerebral, coronary, hepatic and renal blood flows, it is suitable to use in hypertensive patients when decreases in organ blood flows should be avoided. Furthermore, PGE1 improves cardiac function together with reduction of afterload, which is also ideal in hypertensive patients. In conclusion, our results confirmed that induced hypotension with PGE1 can be safely applied to hypertensive patients as can to normotensive patients under keen hemodynamic monitoring. |
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| Practice | Basic medicine |
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| Keywords | Prostaglandin E1, induced hypotenison, hypertensive patients, normotensive patients, hemodynamics |
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