Lerman J, Schmitt-Bantel B I, Gregory G A, Willis M M, Eger E I
Anesthesiology. 1986 Sep;65(3):307-11.
To determine the effect of age on the solubility of volatile anesthetics in human tissues, the authors measured the solubilities of isoflurane, enflurane, halothane, and methoxyflurane in vitro at 37 degrees C in 35 postmortem human tissue specimens. Specimens were taken from neonates, and young (20-50 yr), middle-aged (50-70 yr), and elderly adults (greater than 70 yr). Brain/gas, heart/gas, and liver/gas partition coefficients for all four anesthetics increased significantly (P less than 0.05) between birth and adulthood, although brain/gas partition coefficients in young adults tended to be higher than those in middle-aged and elderly adults. Heart/gas and liver/gas partition coefficients tended to increase with aging. Muscle/gas partition coefficients for the four anesthetics increased linearly with age. Fat/gas partition coefficients did not change significantly with age. Tissue/blood solubilities for the four anesthetics were of the same order of magnitude for a given tissue and age group. Tissue/blood solubilities for enflurane were 30% lower than those for isoflurane in the same tissue and age group. In summary: the solubility of volatile anesthetics in human tissues increases with age; the lower solubility of anesthetics in neonates partially explains the more rapid increase of alveolar and tissue anesthetic partial pressures in neonates; despite the higher blood solubility of enflurane, its lower tissue solubility may explain a rate of recovery comparable with that of isoflurane.
为了确定年龄对挥发性麻醉剂在人体组织中溶解度的影响,作者在37℃下,对35份死后人体组织标本进行了异氟烷、恩氟烷、氟烷和甲氧氟烷的体外溶解度测量。标本取自新生儿、年轻人(20 - 50岁)、中年人(50 - 70岁)和老年人(大于70岁)。所有四种麻醉剂的脑/气、心/气和肝/气分配系数在出生至成年之间均显著增加(P < 0.05),尽管年轻人的脑/气分配系数往往高于中年人和老年人。心/气和肝/气分配系数往往随年龄增长而增加。四种麻醉剂的肌肉/气分配系数随年龄呈线性增加。脂肪/气分配系数随年龄无显著变化。对于给定的组织和年龄组,四种麻醉剂的组织/血溶解度处于同一数量级。在相同的组织和年龄组中,恩氟烷的组织/血溶解度比异氟烷低30%。总之:挥发性麻醉剂在人体组织中的溶解度随年龄增加;麻醉剂在新生儿中较低的溶解度部分解释了新生儿肺泡和组织麻醉分压上升更快的原因;尽管恩氟烷的血溶解度较高,但其较低的组织溶解度可能解释了其与异氟烷相当的恢复速度。