Ward M E, Adu-Gyamfi Y, Strunin L
Br J Anaesth. 1975 Nov;47(11):1199-1204. doi: 10.1093/bja/47.11.1199.
In 32 patients with chronic liver disease, undergoing major abdominal surgery, anaesthesia was induced with either Althesin (alphaxalone and alphadolone acetate) or thiopentone, and maintained with nitrous oxide, oxygen and increments of either pethidine or fentanyl. The patients were ventilated artificially to maintain PaCO, values in the normal range. Pancuronium bromide was used as the muscle relaxant. Liver function tests at 24 hr and 5 day after surgery showed only minor changes compared with findings before operation. There was no significant difference between the Althesin and thiopentone groups. In two patients with severe obstructive jaundice there was difficulty in reversing the effects of pancuronium, but "pancuronium resistance" was observed in all patients. It is concluded that the anaesthetic sequence described, with either Althesin or thiopentone induction, is satisfactory with respect to changes in liver function in patients with chronic liver disease undergoing major surgery.
对32例慢性肝病患者进行腹部大手术时，用阿法沙龙（α-羟孕酮和乙酸α-孕烷醇酮）或硫喷妥钠诱导麻醉，并用氧化亚氮、氧气及追加哌替啶或芬太尼维持麻醉。对患者进行人工通气以使动脉血二氧化碳分压（PaCO₂）值维持在正常范围。使用溴化潘库溴铵作为肌肉松弛剂。术后24小时和5天时的肝功能检查结果显示，与术前相比仅有轻微变化。阿法沙龙组和硫喷妥钠组之间无显著差异。两名重度梗阻性黄疸患者中，潘库溴铵的作用难以逆转，但所有患者均观察到“潘库溴铵抵抗”。结论是，对于接受大手术的慢性肝病患者，上述采用阿法沙龙或硫喷妥钠诱导的麻醉方案，在肝功能变化方面是令人满意的。
