| Japanese |
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| Title | ブタにおける気腹が循環動態に及ぼす影響―気腹ガスによる差異― |
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| Subtitle | 原著 |
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| Authors | 松本早苗*, 藤瀬久美子*, 加藤晶*, 新宮興*, 三上修**, 松田公志** |
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| Organization | *関西医科大学麻酔科学教室, **関西医科大学泌尿器科学教室 |
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| Journal | 循環制御 |
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| Volume | 17 |
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| Number | 2 |
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| Page | 189-196 |
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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 | 「要旨」腹腔鏡下手術中の循環動態の変動は, 気腹に用いる二酸化炭素(CO2)により引き起こされる影響が多いとされる. 本研究では, ブタを用いて空気, 亜酸化窒素, CO2の3種類のガスによる気腹が循環動態に及ぼす影響の差異を検討した. 低腹腔内圧(10mmHg)における心拍出量の増加, 高腹腔内圧(20mmHg)のおける心拍出量の減少などはいずれの気腹ガスでも観察され, 腹腔内圧上昇の循環動態に及ぼす機械的影響と考えられた. CO2による気腹では, 肺動脈圧, 中心静脈圧, 肺動脈閉塞圧の上昇が観察され, さらに亜酸化窒素では高腹腔内圧で肺動脈閉塞圧の上昇が見られた. これらは血液内に吸収されたCO2および亜酸化窒素による交感神経刺激作用の影響と考えられた. |
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| Practice | 基礎医学・関連科学 |
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| Keywords | Pneumoperitoneum, Hemodynamics, Carbon dioxide, Nitrous oxide, Air |
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| English |
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| Title | Hemodynamic Changes during Intra-abdominal Insufflation in Pigs ―Comparison of Air, Nitrous Oxide and Carbon Dioxide― |
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| Authors | Sanae Matsumoto, Kumiko Fujise, Akira Kato, Koh Shingu, Osamu Mikami*, Tadashi Matsuda* |
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| Organization | Departments of Anesthesiology, Kansai Medical University, *Departments of Urology, Kansai Medical University |
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| Journal | Circulation Control |
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| Volume | 17 |
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| Number | 2 |
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| Page | 189-196 |
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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 investigated cardiovascular changes induced by intra-abdominul insufflation of three different inflating gases in five pigs. Anesthesia was induced with intramuscular ketamine and maintained with isoflurane in a mixture of O2/air (FiO2 0.5) and vecuronium. Ventilation was maintained with a fixed volume per minute. Pneumoperitoneum was induced in each pig with air, nitrous oxide (N2O) and carbon dioxide (CO2) after deflation, at 60 min intervals. Heart rate, mean arterial pressure, central venous pressure (CVP), mean pulmonary arterial pressure (MPAP), pulmonary artery occlusion pressure (PAOP) and cardiac output were measured before insufflation, 5 min after inducing pneumoperitoneum：(intra-adominal pressure (IAP) of 10 mmHg and then of 20 mmHg each for 5 min), and after deflation of each gas. PaCO2 increased during CO2 insufflation. Cardiac output increased during insufflation at an IAP of 10 mmHg and decreased when IAP was increased to 20 mmHg regardles of the gas employed, MPAP, CVP and PAOP during CO2 insufflation, and PAOP during N2O insufflation at an IAP of 20 mmHg, increased. Systemic vascular resistance decreased during CO2 insufflation at an IAP of 10 mmHg and increased during CO2 and N2O insufflation at an IAP of 20 mmHg. In conclusion, all gases exerted a mechanical effect, i.e., restriction of venous return when the IAP was 20 mmHg. In addition, absorbed CO2 and N2O seemed to have stimulated sympathetic nervous system and the elevated CO2 probably dilated the vessels directly. (Circ Cont 17：189〜196, 1996) |
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| Practice | Basic medicine |
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| Keywords | Pneumoperitoneum, Hemodynamics, Carbon dioxide, Nitrous oxide, Air |
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