| Japanese |
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| Title | 低血圧麻酔の出血減少効果―画像による評価 |
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| Subtitle | 原著 |
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| Authors | 長田直人*, 東野哲也**, 牧野浩二**, 吉原博幸***, 指宿昌一郎****, 高崎真弓**** |
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| Organization | *宮崎医科大学集中治療部, **宮崎医科大学耳鼻咽喉科, ***宮崎医科大学医療情報部, ****宮崎医科大学麻酔科 |
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| Journal | 循環制御 |
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| Volume | 17 |
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| Number | 1 |
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| Page | 73-76 |
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| Year/Month | 1996/ |
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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 | 「要約」低血圧麻酔が出血を減少させ視野を明瞭にするかどうかを検討した. 鼓室形成術を受ける7名の患者に, 亜酸化窒素とイソフルランを用いて麻酔を行い, トリメタファンで平均動脈圧を2分間で5mmHgずつ50mmHgまで下げた. この間, 術野の血液を30秒間隔で吸引した. 術野の映像を吸引直後から10, 20, 30秒後にコンピュータに取り込み, 血液の存在する場所とそれ以外の場所を数値に変換して, 血液のある場所の比率を求めた. 平均動脈圧70〜75mmHg(n=21), 60〜69mmHg(n=42), 50〜59mmHg(n=42)の3群で比較した. 血液の存在範囲は, いずれの群においても時間とともに有意に増加したが(P<0.01), 平均動脈圧50〜59mmHgの群が, いずれの測定点においてもほかの2群より有意に少なかった(P<0.01). 平均動脈圧を50〜59mmHgに低下させると, 出血を減少させ, 術野を鮮明にすることがわかった. |
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| Practice | 基礎医学・関連科学 |
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| Keywords | Deliberate hypotension, Middle ear microsurgery, Video image |
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| English |
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| Title | Hemostasis Induced by Deliberate Hypotension during Middle Ear Microsurgery：Evaluation Using A Video Image Processing Technique |
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| Authors | Naoto Nagata, Tetsuya Tono, Kouji Makino, Hiroyuki Yosihara, Shoichiro Ibusuki, Mayumi Takasaki |
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| Organization | Intensive Care Division, Miyazaki Medical College Hospital, Department of Otolaryngology, Miyazaki Medical College, Medical Information Division, Miyazaki Medical College, Department of Anesthesiology, Miyazaki Medical College |
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| Journal | Circulation Control |
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| Volume | 17 |
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| Number | 1 |
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| Page | 73-76 |
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| Year/Month | 1996/ |
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| Article | Original article |
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| Publisher | Japan Society of Circulation Control |
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| Abstract | We examined whether the degree of hemostasis during deliberate hypotension depends on mean arterial blood pressure. Anesthesia was maintained wiht 0.8-1.0 % isoflurane and 67 % nitrous oxide in oxygen in 7 patients undergoing middle ear microsurgery. Mean arterial blood pressure was decreased from 75 mmHg to 50 mmHg with trimethaphan (60〜100μg/kg/min). Video images of the surgical field were captured in digital files every 10 sec for 30 sec after blood aspiration. The area of blood in the surgical field was calculated from the digital data and compared with three groups of mean arterial blood pressure：70〜75 mmHg (n=21), 60〜69 mmHg (n=42) and 50〜59 mmHg (n=42). Bleeding increased significantly with time in the three groups (p<0.01). There was no difference between the three groups in the area of blood immediately after aspiration. The area of blood of the group ranging from 50 to 59 mmHg was significantly smaller than those of both of the other groups at each measurement point (p<0.01). It is concluded that hypotensive anesthesia which maintains mean arterial blood pressure of 50〜59 mmHg produces a bloodless surgical field in middle ear microsurgery. (Circ Cont 17：73〜76, 1996) |
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| Practice | Basic medicine |
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| Keywords | Deliberate hypotension, Middle ear microsurgery, Video image |
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