Kochi T, Izumi Y, Isono S, Ide T, Mizuguchi T
Department of Anesthesiology, Chiba University School of Medicine, Japan.
Anesth Analg. 1991 Sep;73(3):327-32. doi: 10.1213/00000539-199109000-00017.
To examine the ventilatory effects of sevoflurane, breathing pattern, airway occlusion pressure waveform, and the mechanical variables of the respiratory system were determined in seven subjects anesthetized with sevoflurane and in an additional seven subjects anesthetized with halothane. All patients breathed 1 MAC of anesthetic using oxygen as the carrier gas, and the measurements were performed in the absence of surgical stimulation. The durations of inspiration and expiration were significantly longer during sevoflurane than during halothane administration. Tidal volumes were larger in the sevoflurane group than in the halothane group. Occlusion pressure waveforms were also markedly different between the two groups. Occlusion pressure during the initial 300-400 ms tended to be less in the sevoflurane-anesthetized than in the halothane-anesthetized subjects. There was no evidence of an active Hering-Breuer reflex with either anesthetic. Mechanical variables of the respiratory system were essentially identical between the two anesthetics. We conclude that (a) the ventilatory effects of halothane and sevoflurane are different, (b) the difference in the respiratory timing and depth of breathing originates from the action of the anesthetics on the central respiratory neural network, and (c) the different shape of the tracheal occlusion pressure may be largely due to the different effects of halothane and sevoflurane on the muscles of the rib cage.
为研究七氟烷的通气效应，我们测定了7例接受七氟烷麻醉的受试者以及另外7例接受氟烷麻醉的受试者的呼吸模式、气道闭塞压波形和呼吸系统的力学变量。所有患者均以氧气作为载气吸入1个最低肺泡有效浓度（MAC）的麻醉药，且测量均在无手术刺激的情况下进行。七氟烷麻醉期间吸气和呼气的持续时间明显长于氟烷麻醉期间。七氟烷组的潮气量大于氟烷组。两组间的闭塞压波形也明显不同。在最初300 - 400毫秒期间，七氟烷麻醉受试者的闭塞压往往低于氟烷麻醉受试者。两种麻醉药均未显示有明显的黑林 - 布雷尔反射。两种麻醉药作用下呼吸系统的力学变量基本相同。我们得出以下结论：（a）氟烷和七氟烷的通气效应不同；（b）呼吸时间和呼吸深度的差异源于麻醉药对中枢呼吸神经网络的作用；（c）气管闭塞压形状不同可能很大程度上归因于氟烷和七氟烷对胸廓肌肉的不同作用。
