Incze F, Kozma R, Vámos Z
Pest Megyei Tanács Semmelweis Kórház-Rendelöintézet, Budapest.
Orv Hetil. 1990 Feb 25;131(8):395-6, 399-404.
Authors carried out during one and a half year 135 anaesthesias with isoflurane. 104 of them was administered in closed, and 31 in semi-closed system. The results were compared with halothane and fentanyl anaesthesias. After brief review of the literature about isoflurane, authors evaluated their own experiences The most favourable result was the stability of the metabolic acid-base balance. One explanation of this feature is the undisturbed oxygenation of the tissues. The circulation was characterized by mild tachycardia and by transitory decrease of the systolic blood pressure. The circulatory parameters were better in closed system, than in semi-closed one, and within the former system the most stable circulation was achieved either by an empirical syringe-injection administration, or by vaporizer administration using 5 -3,8 -3,4 -3 -2,8 -2,5 -2,3 etc.% dosage schedule. The dose-related respiratory depression was of lesser degree, than with fentanyl, and was equal to that with halothane. It was found an also dose-related saving in muscle relaxants. The blood sugar level increased considerably and more prolonged, than with the control anaesthetics. The high cost of the isoflurane (and of any other inhalational agent) was partly compensated by using it in a closed system. Authors found the isoflurane--based on their own experiences and on the data of the literature--suitable for prolonged and repeated anaesthesias too, but they referred to the circumstances also, which required closer attention.
作者在一年半的时间里使用异氟烷进行了135例麻醉。其中104例在紧闭式系统中实施,31例在半紧闭式系统中实施。将结果与氟烷和芬太尼麻醉进行了比较。在简要回顾了关于异氟烷的文献后,作者评估了他们自己的经验。最有利的结果是代谢性酸碱平衡的稳定性。对此特征的一种解释是组织的氧合未受干扰。循环系统的特征是轻度心动过速和收缩压短暂下降。紧闭式系统中的循环参数比半紧闭式系统中的更好,在前一种系统中,通过经验性的注射器注射给药或使用5 - 3.8 - 3.4 - 3 - 2.8 - 2.5 - 2.3等%剂量方案的蒸发器给药可实现最稳定的循环。与芬太尼相比,剂量相关的呼吸抑制程度较轻,与氟烷相当。还发现与剂量相关的肌肉松弛剂节省。血糖水平升高幅度比对照麻醉剂大且持续时间更长。异氟烷(以及任何其他吸入剂)的高成本通过在紧闭式系统中使用而得到部分补偿。基于他们自己的经验和文献数据,作者发现异氟烷也适用于长时间和重复麻醉,但他们也提到了需要更密切关注的情况。