Pittner Antje, Nalos Marek, Theisen Marc, Ploner Franz, Brückner Uwe B, Georgieff Michael, Radermacher Peter, Fröba Gebhard
Sektion Anästhesiologie Pathophysiologie und Verfahrensentwicklung, Universitätsklinik für Anästhesiologie, Chirurgische Universitätsklinik Ulm, Parkstrasse 11, 89073 Ulm, Germany.
Anesth Analg. 2002 Jun;94(6):1510-6, table of contents. doi: 10.1097/00000539-200206000-00025.
Xenon (Xe) is less soluble than nitrous oxide (N(2)O) and hence may be more suitable during bowel obstruction. Therefore, we compared the intestinal mechanical and biochemical effects of these two gases with those of total IV anesthesia in a porcine model of small-bowel obstruction. Intestinal obstruction was induced in 33 anesthetized pigs, in 18 of which segmental ileal perfusion was reduced by partial arterial occlusion. Pigs received total IV anesthesia, Xe, or N(2)O (in 30% oxygen) for 4 h, and we determined the intraluminal pressure and volume, the arterial-ileal PCO(2) gap, and the lactate and pyruvate levels in the segmental mesenteric vein. Under both experimental conditions, Xe or N(2)O ventilation caused the volume to significantly increase with a concomitant significant increase in the intraluminal pressure during N(2)O ventilation. Regardless of the anesthesia technique, none of the biochemical variables was influenced in the animals with maintained ileal blood supply. In contrast, reducing the segmental perfusion induced pronounced alterations of all variables of bowel wall energy metabolism. The type of anesthesia, however, had no further statistically significant effect. Short-term inhalation of Xe or N(2)O seems to have no deleterious effects on the metabolic balance of the gut wall during intestinal obstruction.
In anesthetized pigs, short-term inhalation of xenon or nitrous oxide over 4 h when compared with total IV anesthesia had no additional deleterious effects on the metabolic balance of the gut wall during intestinal obstruction, no matter whether the arterial blood flow was reduced or not.
氙气(Xe)的溶解度低于一氧化二氮(N₂O),因此在肠梗阻期间可能更适用。所以,我们在猪小肠梗阻模型中比较了这两种气体与全静脉麻醉对肠道机械和生化的影响。对33只麻醉猪诱导肠梗阻,其中18只通过部分动脉闭塞使节段性回肠灌注减少。猪接受全静脉麻醉、氙气或一氧化二氮(在30%氧气中)4小时,我们测定管腔内压力和容积、动脉-回肠PCO₂差值以及节段性肠系膜静脉中的乳酸和丙酮酸水平。在两种实验条件下,氙气或一氧化二氮通气均使容积显著增加,且在一氧化二氮通气期间管腔内压力随之显著升高。无论采用何种麻醉技术,回肠血供维持正常的动物的生化变量均未受影响。相比之下,节段性灌注减少导致肠壁能量代谢的所有变量发生明显改变。然而,麻醉类型没有进一步的统计学显著影响。在肠梗阻期间,短期吸入氙气或一氧化二氮似乎对肠壁的代谢平衡没有有害影响。
在麻醉猪中,与全静脉麻醉相比,在肠梗阻期间短期吸入氙气或一氧化二氮4小时,无论动脉血流是否减少,对肠壁的代谢平衡均无额外的有害影响。