Yu Bu-Wei, Matsumoto Nobuyuki
Department of Anesthesiology, Chang-hai Hospital, The Second Military Medical University, Shanghai, China.
Department of Anesthesiology, Saitama Medical School, 38 Morohongo, Moroyama, Iruma-gun, 350-04, Saitama, Japan.
J Anesth. 1997 Sep;11(3):213-218. doi: 10.1007/BF02480040.
Effects of sevoflurane and halothane anesthesia on liver circulation and oxygen metabolism during hepatolobectomy were investigated in the dog, with the aim of choosing a better anesthetic for hepatic resection.
Sixteen mongrel dogs were randomly divided into two groups with eight in each. Electromagnetic flowmeters were used to measure hepatic arterial and portal venous blood flows (1) before the inhalation of each anesthetic (base line); (2) 1 h after the start of inhalation of 1.5 minimum alveolar concentration (MAC) anesthetic; (3) 1 h after hepatolobectomy with the same MAC of anesthesia; and (4) 2 h after the discontinuation of anesthesia. Measurements of systemic hemodynamics, blood gas tensions, plasma enzyme leaks and arterial ketone body ratio were made at the same time.
Sevoflurane maintained hepatic arterial blood flow better than halothane anesthesia, both before and after hepatolobectomy. Hepatic arterial vascular resistance increased in the halothane group but did not change in the sevoflurane group after hepatolobectomy. No significant difference was found in oxygen metabolism and arterial ketone body ratio between two groups. Serum enzyme leakage was less in the sevoflurane group.
Sevoflurane has less adverse effects on liver circulation, especially hepatic arterial blood flow, and hepatic function than halothane in the case of hepatolobectomy.
在犬肝叶切除术中研究七氟烷和氟烷麻醉对肝脏循环及氧代谢的影响,旨在为肝切除术选择一种更优的麻醉剂。
16只杂种犬随机分为两组,每组8只。使用电磁流量计测量(1)吸入每种麻醉剂前(基线);(2)吸入1.5倍最低肺泡浓度(MAC)麻醉剂开始后1小时;(3)相同MAC麻醉下肝叶切除术后1小时;以及(4)麻醉停止后2小时的肝动脉和门静脉血流量。同时测量全身血流动力学、血气张力、血浆酶漏出及动脉酮体比率。
在肝叶切除术前及术后,七氟烷维持肝动脉血流的效果均优于氟烷麻醉。氟烷组肝动脉血管阻力增加,而七氟烷组在肝叶切除术后未发生变化。两组在氧代谢和动脉酮体比率方面未发现显著差异。七氟烷组血清酶漏出较少。
在肝叶切除术病例中,与氟烷相比,七氟烷对肝脏循环尤其是肝动脉血流及肝功能的不良影响较小。