Laster M J, Taheri S, Eger E I, Liu J, Rampil I J, Dwyer R
Department of Anesthesia, University of California, San Francisco 94143-0464.
Anesth Analg. 1991 Aug;73(2):209-12. doi: 10.1213/00000539-199108000-00016.
Percutaneous loss of inhaled anesthetics is small relative to their uptake. The minor nature of this loss results in part from the substantial barrier to diffusion posed by the skin. Pleural and peritoneal surfaces pose less effective barriers because diffusion distances are smaller than in the skin. Accordingly, we measured visceral loss to air of desflurane, isoflurane, and halothane from pleural and peritoneal surfaces in five juvenile swine. Pleural and peritoneal losses per percent end-tidal anesthetic correlated directly with the solubility of the anesthetic in blood or tissues. The total pleural losses for the first 30 min of anesthetic administration were desflurane, 1.22 +/- 0.22 mL (mean +/- standard deviation for the 30-min period); isoflurane, 2.34 +/- 0.52 mL; and halothane, 4.69 +/- 0.98 mL; respective peritoneal losses were 0.64 +/- 0.12 mL, 1.23 +/- 0.25 mL, and 2.69 +/- 0.57 mL. Pleural loss per unit time did not change with increasing duration of anesthesia, whereas peritoneal loss increased for all anesthetics. These visceral losses are greater than total percutaneous losses in humans given these anesthetics for the same period of time, but the loss of anesthetic by either route is too small to affect measurements of anesthetic kinetics or recovery.
与吸入麻醉药的摄取相比，经皮损失量较小。这种损失量较小的部分原因是皮肤构成了实质性的扩散屏障。胸膜和腹膜表面构成的屏障作用较弱，因为扩散距离比皮肤中的小。因此，我们测量了五只幼年猪胸膜和腹膜表面地氟烷、异氟烷和氟烷向空气中的内脏损失量。每百分比呼气末麻醉药的胸膜和腹膜损失量与麻醉药在血液或组织中的溶解度直接相关。麻醉给药的前30分钟内，总的胸膜损失量分别为：地氟烷1.22±0.22毫升（30分钟期间的平均值±标准差）；异氟烷2.34±0.52毫升；氟烷4.69±0.98毫升；相应的腹膜损失量分别为0.64±0.12毫升、1.23±0.25毫升和2.69±0.57毫升。单位时间的胸膜损失量不会随着麻醉持续时间的增加而改变，而所有麻醉药的腹膜损失量都会增加。在相同时间段内接受这些麻醉药的人类中，这些内脏损失量大于总的经皮损失量，但通过任何一种途径的麻醉药损失量都太小，不足以影响麻醉动力学或恢复的测量。
