Musser J B, Fontana J L, Mongan P D
Walter Reed Army Medical Center, Washington, District of Columbia, USA.
Anesth Analg. 1999 Mar;88(3):671-5. doi: 10.1097/00000539-199903000-00038.
The i.v. administration of < or = 9 mL of nonvaporized liquid halothane causes significant pulmonary damage, cardiovascular decompensation, and death. To determine whether liquid halothane mixed in a lipid emulsion would alter these toxic effects, six swine were evaluated in a randomized cross-over study. The pulmonary, analgesic, hemodynamic, and histopathologic effects of liquid halothane (25 mL) mixed with a liquid carrier (475 mL, Liposyn III 20%) and administered by constant infusion were compared with halothane administered by a calibrated vaporizer. Three swine received the halothane lipid emulsion (HLE), followed by inhaled halothane. Three additional swine received inhaled halothane, followed by the HLE. There were no changes in pulmonary compliance or arterial blood gases during or after the administration of equivalent volumes of halothane (13.75 mL) either by infusion of HLE or by inhalation of halothane. The end-tidal halothane concentration for the minimum alveolar anesthetic concentration was 0.79% +/- 0.08% during HLE administration and 1.13% +/- 0.12% for inhaled halothane (P < 0.001). Hemodynamic variables and blood halothane levels by gas chromatography were measured at end-tidal concentrations of 0.6%, 1.2%, and 1.8%. Blood halothane levels (mg/mL) were significantly higher (P < 0.05) after the administration of HLE at end-tidal halothane concentrations of 1.2% (0.49 +/- 0.19 vs 0.82 +/- 0.18) and 1.8% (0.79 +/- 0.17 vs 1.29 +/- 0.34). When compared at equivalent blood levels, HLE caused fewer changes in the left ventricular end-diastolic pressure, mean arterial pressure, and dP/dt than inhaled halothane. There was no evidence of pulmonary histopathologic damage 4-8 h after the infusion of 500-700 mL of HLE. This novel method of delivery of a volatile anesthetic seems to lack the toxicity of direct i.v. administration of liquid halothane. It may be a useful alternative to traditional administration via a vaporizer.
Halothane causes pulmonary dysfunction and death when given i.v. in liquid form. Six swine received a halothane lipid emulsion i.v. to evaluate the anesthetic and physiologic effects. No pulmonary toxicity or deaths were associated with the halothane lipid emulsion. The anesthetic profile was similar to delivery of halothane via a vaporizer.
静脉注射≤9毫升未汽化的液态氟烷会导致严重的肺损伤、心血管代偿失调和死亡。为了确定混入脂质乳剂中的液态氟烷是否会改变这些毒性作用，在一项随机交叉研究中对6头猪进行了评估。将液态氟烷（25毫升）与液体载体（475毫升，Liposyn III 20%）混合并通过持续输注给药，其对肺、镇痛、血流动力学和组织病理学的影响与通过校准蒸发器给药的氟烷进行了比较。3头猪先接受氟烷脂质乳剂（HLE），然后吸入氟烷。另外3头猪先吸入氟烷，然后接受HLE。通过输注HLE或吸入氟烷给予等量氟烷（13.75毫升）期间及之后，肺顺应性或动脉血气均无变化。HLE给药期间，最低肺泡有效浓度时的呼气末氟烷浓度为0.79%±0.08%，吸入氟烷时为1.13%±0.12%（P<0.001）。在呼气末浓度为0.6%、1.2%和1.8%时测量血流动力学变量和通过气相色谱法测定的血氟烷水平。在呼气末氟烷浓度为1.2%（0.49±0.19对0.82±0.18）和1.8%（0.79±0.17对1.2
