Uno T, Hashida K, Yorozuya Y, Miyako M, Itohda Y
Department of Anesthesiology, Oita Prefectural Hospital.
Masui. 1990 Feb;39(2):144-7.
We used the laser flowmeter to measure and compare the effect of nitroglycerin (TNG), trimetaphan (TMP) and prostaglandin E1 (PGE1) on the blood flow of operating field during hypotension induced by each drug. The study was done in 33 patients (TNG:13, TMP:13 and PGE1:7) anesthetized with modified NLA who underwent radical mastectomy. We put the probe of the laser flowmeter on the skin of the opposite breast to the operating field and measured the skin blood flow change. Measurements were made before and during hypotension induced by each drug. TMP-induced hypotension decreased blood flow significantly (P less than 0.05), but TNG and PGE1 had no significant effect. Intraoperative blood losses of TNG and PGE1 group were not significantly larger than that of TMP group. From this study we conclude that TNG, TMP and PGE1 can dry the operating field and decrease intraoperative blood loss similarly. Therefore we should choose the drugs to induce hypotension considering the effect of the drug on blood flow of the important organs and each patient's complications.
我们使用激光流量计来测量和比较硝酸甘油(TNG)、三甲噻芬(TMP)和前列腺素E1(PGE1)在每种药物诱导低血压期间对术野血流的影响。该研究在33例接受改良NLA麻醉并进行根治性乳房切除术的患者中进行(TNG组13例、TMP组13例和PGE1组7例)。我们将激光流量计的探头置于与术野相对的乳房皮肤上,测量皮肤血流变化。在每种药物诱导低血压之前和期间进行测量。TMP诱导的低血压使血流显著减少(P<0.05),但TNG和PGE1无显著影响。TNG组和PGE1组术中失血量不比TMP组显著增多。从本研究我们得出结论,TNG、TMP和PGE1均可同样地使术野干燥并减少术中失血。因此,我们应考虑药物对重要器官血流的影响及每位患者的并发症来选择诱导低血压的药物。