Landauer B, Tölle W, Kolb E
Prakt Anaesth. 1977 Oct;12(5):359-70.
Halothane, momentarily the most popular inhalation anaesthetic, was examined in respect of its surfactant irritating properties in 13 rabbits. After five hours IPPB-anaesthesia with this compound there was a highly significant fall of the compliance quotient (CQ), at the moment the most reliable criterion for the surfactant activity "in situ", from 3.34 to 2.76. Lung histology revealed patchy atelectasis, dystelectasis and interstitial edema. In contrast to this remarkable mechanical and structural deterioration, blood gas analyses showed a surprising stability of gas exchange, hinting a tremendous functional reserve. Postnarcotic examination of lung extracts in the Wilhelmy balance exhibited no persistent damage of the specific alveolar lining layer. On the basis of these experimental findings we recommend that halothane should not be used in patients with preexisting impairment of pulmonary surfactant system.
氟烷曾一度是最常用的吸入性麻醉剂,我们对13只兔子进行了其对表面活性剂刺激性的研究。使用该化合物进行5小时间歇性正压通气麻醉后,顺应性商数(CQ)出现了极显著下降,CQ是当时“原位”表面活性剂活性最可靠的标准,从3.34降至2.76。肺部组织学显示有斑片状肺不张、肺膨胀不全和间质性水肿。与这种明显的机械和结构恶化形成对比的是,血气分析显示气体交换出人意料地稳定,这表明有巨大的功能储备。麻醉后用威尔海姆天平对肺提取物进行检查,未发现特定肺泡内衬层有持续性损伤。基于这些实验结果,我们建议,对于已存在肺表面活性剂系统受损的患者,不应使用氟烷。