Benumof J L, Augustine S D, Gibbons J A
Department of Anesthesia, University of California, San Diego, La Jolla 92093.
Anesthesiology. 1987 Dec;67(6):910-5. doi: 10.1097/00000542-198712000-00006.
Controversy exists as to whether the halogenated inhalation (IH) anesthetics impair arterial oxygenation during one-lung ventilation (1-LV). Accordingly, the authors have answered this question in 12 consenting patients who required 1-LV to facilitate the performance of thoracic surgery, by comparing arterial oxygenation during a prolonged period of IH anesthesia with arterial oxygenation during a prolonged period of intravenous (IV) anesthesia during stable 1-LV conditions. The patients were equally divided into halothane and isoflurane groups. Each patient in each IH anesthetic group underwent the following experimental sequence: step 1, two-lung ventilation (2-LV), 1 MAC IH anesthesia; step 2, 1-LV, 1 MAC IH anesthesia; step 3, 1-LV, iv anesthesia; step 4, 2-LV, iv anesthesia. Stable 1-LV conditions were proven by serial arterial blood gas measurement. Conversion from 2-LV to 1-LV during IH anesthesia (step 1 to step 2) caused a very large and significant decrease in PaO2 (from 484 +/- 49 to 116 +/- 61, and from 442 +/- 58 to 232 +/- 97 mmHg in the halothane and isoflurane groups, respectively) and increase in shunt (from 14 +/- 4 to 44 +/- 9, and from 19 +/- 5 to 31 +/- 8% in the halothane and isoflurane groups, respectively).(ABSTRACT TRUNCATED AT 250 WORDS)
关于卤化吸入麻醉剂在单肺通气（1-LV）期间是否会损害动脉氧合存在争议。因此，作者通过比较在稳定的1-LV条件下长时间卤化吸入（IH）麻醉期间的动脉氧合与长时间静脉（IV）麻醉期间的动脉氧合，在12例需要1-LV以方便进行胸外科手术的自愿受试者中回答了这个问题。患者被平均分为氟烷组和异氟烷组。每个接受IH麻醉的患者组中的每位患者都经历了以下实验步骤：步骤1，双肺通气（2-LV），1个最低肺泡有效浓度（MAC）的IH麻醉；步骤2，1-LV，1个MAC的IH麻醉；步骤3，1-LV，静脉麻醉；步骤4，2-LV，静脉麻醉。通过连续动脉血气测量证明了稳定的1-LV条件。在IH麻醉期间从2-LV转换为1-LV（步骤1至步骤2）导致动脉血氧分压（PaO2）非常大幅度且显著下降（氟烷组和异氟烷组分别从484±49降至116±61，以及从442±58降至232±97 mmHg），分流增加（氟烷组和异氟烷组分别从14±4增至44±9，以及从19±5增至31±8%）。（摘要截短于250字）
