| Japanese |
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| Title | 冠動脈バイパス術における人工心肺離脱前のアムリノン一回投与量の検討 |
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| Subtitle | 原著 |
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| Authors | 謝慶一*1, 下川充*1, 北口勝康*1, 古家仁*1, 庭屋和夫*2, 北村惣一郎*2 |
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| Organization | *1奈良県立医科大学麻酔科学教室, *2奈良県立医科大学第三外科学教室 |
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| Journal | 循環制御 |
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| Volume | 18 |
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| Number | 2 |
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| Page | 213-217 |
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| Year/Month | 1997/ |
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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 | 冠動脈バイパス術患者69例に対して人工心肺離脱時にアムリノンを投与するに際して適正な一回投与量を検討した. 全症例を4群(少量投与群 : 0.8±0.1mg・kg-1 ; 15例, 中等量投与群 : 1.0±0.1mg・kg-1 ; 18例, 大量投与群 : 1.6±0.2mg・kg-1 ; 18例, 非投与群 : 18例)に分け一回投与の後, 5μg・kg-1・min-1で持続投与し, 心肺離脱直後, 1時間後, 閉胸後の血行動態を比較し検討した. 結果は心肺離脱直後収縮期血圧は大量投与群が少量投与群及び非投与群に比べ低値を示し, また中等量投与群が非投与群に比べ有意に低値を示した. 少量投与群では閉胸後収縮期血圧は離脱直後に比べ有意に, また中等量及び大量投与群では閉胸後において離脱直後と1時間後に比べ, さらに1時間後において離脱直後に比べ有意に上昇していた. 心拍出量では離脱直後及び閉胸後に非投与群が中等量投与群に比べ有意に低値を示した. 少量投与群では閉胸後が1時間後に比べ心拍出量は有意に低下し, 非投与群では1時間後が離脱直後に比べ有意に上昇し, 閉胸後が1時間後に比べ有意に低下した. 冠動脈バイパス術において人工心肺離脱時のアムリノン投与量は持続投与量が5μg・kg-1・min-1の場合, 一回投与量は大量投与(1.6±0.2mg・kg-1)では心肺離脱直後に平均血圧が有意に低下し, 少量投与群(0.8±0.1mg・kg-1)では, 閉胸後の心拍出量の低下が高度であったため, 中等量(1.0±0.1mg・kg-1)が適量であると考えられた. |
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| Practice | 基礎医学・関連科学 |
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| English |
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| Title | Evaluation of the Optimal Single Dose of Amrinone during Cardiopulmonary Bypass on Coronary Artery Bypass Surgery. |
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| Authors | Keiichi Sha*1, Mitsuru Shimokawa*1, Katsuyasu Kitaguchi*1, Hitoshi Furuya*1, Kazuo Niwaya*2, Soichiro Kitamura*2 |
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| Organization | *1Departments of Anesthesiology, Nara Medical University, *2Departments of Surgery III, Nara Medical University |
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| Journal | Circulation Control |
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| Volume | 18 |
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| Number | 2 |
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| Page | 213-217 |
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| Year/Month | 1997/ |
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| Article | Original article |
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| Publisher | Japan Society of Circulation Control |
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| Abstract | We evaluated the optimal single dose of Amrinone during cardiopulmonary bypass (CPB) on coronary artery bypass graft surgery. The study population comprised 69 adult patients, and they were divided to four groups (low dose Amrinone group ; 0.8±0.1mg・kg-1 : n=15, moderate dose Amrinone group ; 1.0±0.1mg ・kg-1 : n=18, high dose Amrinone group ; 1.6±0.2mg・kg-1 : n=18 and non Amrinone group : n=18). Amrinone was administered into the venous reservoir near the end of CPB, followed by intravenous infusions with 5μg・kg-1・min-1 in Amrinone groups. Hemodynamic measurement were determined at immediately after CPB, at one hour after CPB and after the chest closure. The systolic blood pressure reduced significantly in high dose group compared with low dose and non Amrinone groups, and in moderate dose group compared with non Amrinone group at immediately after CPB. The cardiac output reduced significantly in non Amrinone group compared with moderate dose group at immediately after CPB and after the chest closure, and decreased significantly after the chest closure compared with one hour after CPB on low dose and non Amrinone groups. The moderate single dose Amrinone (1.0±0.1mg・kg-1) during cardiopulmonary bypass followed by intravenous infusions of 5μg・kg-1・min-1 was optimal for coronary artery bypass graft surgery, because the systolic blood pressure reduced significantly in the high dose Amrinone (1.6±0.2mg・kg-1) compared with the low dose Amrinone (0.8±0.1mg. kg-1) at immediately after CPB, and the cardiac output decreased significantly after the chest closure compared with one hour after CPB on low dose group. |
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| Practice | Basic medicine |
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