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手术期间全身麻醉药对人体胃内容物pH值的影响:氟烷、氟烯醚和环丙烷麻醉的调查

Effects of general anaesthetics on the pH of gastric contents in man during surgery: a survey of halothane, fluoroxene and cyclopropane anesthesia.

作者信息

Christensen V, Skovsted P

出版信息

Acta Anaesthesiol Scand. 1975;19(1):49-54. doi: 10.1111/j.1399-6576.1975.tb05221.x.

Abstract

The effect of premedication and three general anaesthetics on gastric content pH was investigated. Neither premedication with pentobarbital-atropine nor morphine-scopolamine given 1-2 h prior to anaesthesia appeared to affect the acidity of the gastric contents. Halothane invaribly increased the pH of the gastric contents; none of the seven patients studied had a gastric pH of less than 2.5 (mean 5.1) after 1 h of anesthesia. Cyclopropane uniformly maintained the acidity of the gastric contents; only one out of seven patients had a gastric content pH above 2.5 (mean 1.7) after 1 h of anaesthesia. This effect of cyclopropane in maintaining the pH of gastric contents was unaffected by the use of premedication and induction with thiopental. Fluorexene affected the pH of the gastric contents much less uniformly. Although the pH for the group as a whole gradually increased (after one hour from 1.7 plus or minus 0.2 (s.e. mean) to 3.1 plus or minus 0.7), some of the seven patients studied reacted to fluroxene with a constant low gastric content pH. The findings are discussed, and it is concluded that the risk of pulmonary complications in case of vomiting and aspiration upon emergence from anaesthesia is greater if the anaesthetic agent is cyclopropane or fluoroxene, than if it is halothane.

摘要

研究了术前用药和三种全身麻醉药对胃内容物pH值的影响。麻醉前1 - 2小时给予戊巴比妥 - 阿托品或吗啡 - 东莨菪碱进行术前用药,似乎均不影响胃内容物的酸度。氟烷总是会使胃内容物的pH值升高;在接受研究的7名患者中,麻醉1小时后,没有一人的胃pH值低于2.5(平均为5.1)。环丙烷能始终维持胃内容物的酸度;7名患者中只有1人在麻醉1小时后胃内容物pH值高于2.5(平均为1.7)。环丙烷维持胃内容物pH值的这种作用不受术前用药以及硫喷妥钠诱导的影响。氟烯对胃内容物pH值的影响则不太一致。尽管整个组的pH值逐渐升高(1小时后从1.7±0.2(标准误均值)升至3.1±0.7),但在接受研究的7名患者中,一些患者对氟烯的反应是胃内容物pH值持续偏低。对这些研究结果进行了讨论,并得出结论:与使用氟烷相比,麻醉苏醒期呕吐和误吸时,如果麻醉药是环丙烷或氟烯,发生肺部并发症的风险更大。

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