Romo-Salas F, Aldrete J A, Franatovic Y
Surg Gynecol Obstet. 1980 Apr;150(4):551-4.
Alleged injury to the liver by halogenated hydrocarbon anesthetic agents has led to greater use of balanced anesthesia with analgesics, tranquilizers and nitrous oxide and oxygen. Reports of high intrabiliary pressures and bizarre cholangiograms for patients under such anesthesia led us to investigate the specific effects on intrabiliary pressure of morphine sulfate, fentanyl and butorphanol tartrate, each at two different dosage levels. After control measurements were taken, all of the guinea pigs, an animal with a biliary tract much like that of man, were injected with a different drug, dosage level or with 0.9 per cent saline solution, and changes in intrabiliary pressure were recorded every five minutes. Both high and low dosages of morphine and fentanyl produced marked and statistically significant increases in the intrabiliary pressure. In contrast, equianalgesic dosage of butorphanol produced little or no increase. Since two of these drugs can elevate intrabiliary pressure significantly above pretreatment values, it is recommended that dilations of the biliary tract occurring during operative cholangiograms be interpreted with caution.
卤代烃麻醉剂对肝脏的所谓损伤导致了镇痛药、镇静剂以及氧化亚氮和氧气联合使用的平衡麻醉法的更多应用。关于接受此类麻醉的患者出现高胆管内压力和异常胆管造影的报告促使我们研究硫酸吗啡、芬太尼和酒石酸布托啡诺在两种不同剂量水平下对胆管内压力的具体影响。在进行对照测量后，对所有豚鼠（一种胆管系统与人类非常相似的动物）注射不同的药物、剂量水平或0.9%的盐溶液，并每隔五分钟记录胆管内压力的变化。高剂量和低剂量的吗啡及芬太尼均使胆管内压力显著升高且具有统计学意义。相比之下，等效镇痛剂量的布托啡诺几乎未引起或未引起压力升高。由于其中两种药物可使胆管内压力显著高于预处理值，因此建议在手术胆管造影期间出现的胆道扩张应谨慎解读。
