Japanese
Title心機能におけるCa2+拮抗薬と麻酔薬 -臨床における相互作用-
Subtitle特集
Authors福崎誠*, 柴田治*, 冨安志郎*, 辻田俊也*, 藤垣徹*, 後藤裕*
Authors(kana)
Organization*長崎大学医学部麻酔学教室
Journal循環制御
Volume11
Number4
Page475-482
Year/Month1990/
Article報告
Publisher日本循環制御医学会
Abstract「要旨」NLA麻酔下にニカルジピンNCR, ディルチアゼムDLを単独に, または各々にエンフルレンEnf., ハロセンHal.を併用し, 収縮期圧を投与前値の70%に低下させた際の心血行動態に及ぼす相互作用を検討した. 投与中は心拍数はNCR群で増加, DL群で減少し, 心拍出量はNCR群およびDL単独群で増加, DL+Enf., Hal.併用群で減少した. 全末梢血管抵抗はNCR群, DL単独群で減少, DL+Enf., Hal.併用群で不変を示した. 平均肺動脈楔入圧・右室仕事量はNCR群とDL単独群で軽度増加, DL+Enf., Hal.併用群で軽度減少した. 左室仕事量は全群で減少した. DL群では房室ブロックが出現した. 以上より, NCRは吸入麻酔薬の併用下でも血管拡張作用のみしか出現しないが, DLはその併用にて心抑制作用が相加される. 「はじめに」Ca2+拮抗薬は心筋において主に細胞内へのCa2+流入抑制に基づき心収縮力低下等の心抑制作用を来たす. また, 吸入麻酔薬も作用点は明確ではないが心収縮力低下をはじめ, 洞・房室結節機能低下の心抑制作用を来たす1)〜6). 従って, それらの併用により各々の心抑制作用が相加あるいは相乗的に出現することが考えられる.
Practice基礎医学・関連科学
Keywordscardiovascular effects, interaction, calcium channel blocking drugs, inhalation anesthetics
English
TitleClinical interactions between calcium channel blocking drugs and inhalation anesthetics on cardiovascular effects
Subtitle
AuthorsMakoto Fukusaki, Osamu Shibata, Shiro Tomiyasu, Toshiya Tsujita, Toru Fujigaki, Yutaka Goto
Authors(kana)
OrganizationDepartment of Anesthesiology Faculty of Medicine University of Nagasaki
JournalCirculation Control
Volume11
Number4
Page475-482
Year/Month1990/
ArticleReport
PublisherJapan Society of Circulation Control
AbstractThis study examines the interactions of induced hypotension with the combination of calcium channel blocking drugs (Nicardipine NCR, Diltiazem DL)and inhalation anesthetics (0.7% Enflurane, 0.4% Halothane)upon hemodynamics during neurosurgery under neuroleptanesthesia (N2O 60%). (Group I=NCR only, Group II=NCR+Enf., Group III=NCR+Hal., Group IV=DL only, Group V=DL+Enf., Group VI=DL+Hal.) A 30% reduction in systolic blood pressure was achieved and maintained for 30-60 minutes. The following effects were observed. 1) Heart rate was increased in group I and II, but was decreased in group IV, V and VI. 2) Cardiac output was increased in group I and II, but was decreased in group V and VI. 3)Systemic vascular resistance was decreased in group I, II, III and IV, but showed no change in group V and VI. 4) Mean pulmonary capillary wedge pressure was slightly increased in group I, II, III and IV, but was slightly decreased in group V and VI. 5) Left ventricular stroke work was decreased in all groups. 6) AV-block was observed in 4 cases of group IV, V and VI. These results suggest that cardiac dysfunction is not observed during induced hypotension with the combination of NCR and inhalation anesthetics, but is observed with the combination of DL and inhalation anesthetics.
PracticeBasic medicine
Keywordscardiovascular effects, interaction, calcium channel blocking drugs, inhalation anesthetics

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