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[人类在氟烷、异氟烷或恩氟烷麻醉期间对二氧化碳通气反应的分析]

[An analysis of the ventilatory response to carbon dioxide during halothane, isoflurane, or enflurane anesthesia in humans].

作者信息

Izumi Y, Kochi T, Mizuguchi T

机构信息

Department of Anesthesia, Tochigi Cancer Center, Utsunomiya.

出版信息

Masui. 1991 Aug;40(8):1222-7.

PMID:1920800
Abstract

To analyze the effects of halothane, isoflurane, or enflurane on the ventilatory response to CO2, minute volume (VE), respiratory rate (f), occlusion pressure, mean inspiratory flow rate (VT/TI), and effective elastance (Pmax/VT) were measured in 26 patients during quiet breathing and when the respiratory system was stressed by CO2. Comparison was made at equipotent anesthetic concentration (1 MAC) and all measurements were made in the absence of surgical stimulation. Respiratory rate and Pmax/VT were unchanged in all groups after end-tidal CO2 was elevated. By contrast, VE, VT/TI, and occlusion pressure increased in all the groups when the respiratory system was stressed by CO2. Among the parameters tested delta VE/delta PaCO2 and delta VT/TI/delta PaCO2 were significantly (P less than 0.05) greater during halothane anesthesia than during isoflurane or enflurane anesthesia. We conclude that, at equipotent anesthetic concentrations, isoflurane and enflurane depress CO2 chemosensitivity more than halothane does, and that such effect is primarily related to the greater depressant effects of isoflurane and enflurane on the respiratory driving mechanisms.

摘要

为分析氟烷、异氟烷或恩氟烷对二氧化碳通气反应的影响,在26例患者安静呼吸时以及呼吸系统受到二氧化碳刺激时,测量了分钟通气量(VE)、呼吸频率(f)、阻断压、平均吸气流速(VT/TI)和有效弹性(Pmax/VT)。在等效麻醉浓度(1 MAC)下进行比较,且所有测量均在无手术刺激的情况下进行。呼气末二氧化碳升高后,所有组的呼吸频率和Pmax/VT均未改变。相比之下,当呼吸系统受到二氧化碳刺激时,所有组的VE、VT/TI和阻断压均升高。在测试的参数中,氟烷麻醉期间的ΔVE/ΔPaCO2和ΔVT/TI/ΔPaCO2显著(P<0.05)高于异氟烷或恩氟烷麻醉期间。我们得出结论,在等效麻醉浓度下,异氟烷和恩氟烷比氟烷更能抑制二氧化碳化学敏感性,且这种作用主要与异氟烷和恩氟烷对呼吸驱动机制的更大抑制作用有关。

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