Hayakawa J, Shibata T, Ono K, Usuda Y
Department of Anesthesia, Kanagawa Cancer Center Hospital, Yokohama.
Masui. 1990 Nov;39(11):1467-72.
Arterial blood-gases were evaluated before, during and after the vasodilator induced hypotension in patients undergoing mastectomy. Forty-two patients studied were anesthetized with halothane and nitrous oxide in oxygen. They were divided into following four groups according to vasodilators used: trimetaphan (TMP), nitroglycerin (TNG), adenosine triphosphate (ATP), and prostaglandin E1 (PGE1). Significant reduction in PaO2 was observed during induced hypotension in all groups. However, there was no difference in the degree of PaO2 decrease among four groups. A small but significant increase in PaCO2 and a decrease in pH were observed during and/or after hypotension with TNG and PGE1. These findings suggest that induced hypotension may impair the pulmonary gas exchange by decreased cardiac output and/or change in ventilation-perfusion ratio regardless of vasodilators used. Therefore, continuous arterial blood-gas monitoring should be desirable under these conditions.
对接受乳房切除术的患者在血管扩张剂诱发低血压之前、期间和之后进行动脉血气评估。研究的42例患者采用氟烷和氧化亚氮加氧气进行麻醉。根据所用血管扩张剂,将他们分为以下四组:阿方那特(TMP)、硝酸甘油(TNG)、三磷酸腺苷(ATP)和前列腺素E1(PGE1)。所有组在诱发低血压期间均观察到PaO2显著降低。然而,四组之间PaO2降低程度没有差异。在使用TNG和PGE1诱发低血压期间和/或之后,观察到PaCO2有小幅但显著升高,pH值降低。这些发现表明,无论使用何种血管扩张剂,诱发低血压可能通过心输出量降低和/或通气-灌注比改变而损害肺气体交换。因此,在这些情况下,持续进行动脉血气监测是可取的。