Oku S, Kadowaki T, Uemura T, Nishioka H
Department of Anesthesia and Urology, Saiseikai-Tondabayashi Hospital.
Nihon Hinyokika Gakkai Zasshi. 1993 Feb;84(2):374-81. doi: 10.5980/jpnjurol1989.84.374.
Nineteen patients (mean age, 70 years; range, 58-80 years) undergoing elective transurethral resection of benign hypertrophy of the prostate (mean weight of resectate, 25 g; range 10-59 g; mean resection time, 61 min; range 45-80 min) under spinal anesthesia were studied for early detection of absorption of irrigating solution by means of expired breath alcohol analysis. The irrigating fluid used in all resections was tenfold diluted Urigal solution containing 1% ethanol. Expired breath was collected into a rubber bag every 10 min during the surgery, and the concentration of ethanol was analyzed using a gas detector tube (GASTEC LTD.). Hemodynamic parameters including central venous pressure were routinely measured at the same intervals. The volumetric fluid balance was measured every 20 min. Blood was collected preoperatively, at the same 20-min intervals during the resection, and 4-6 hours after the end of the operation. Serum electrolytes, hemoglobin and total plasma protein concentration were measured, and blood gas tension was analyzed. Mean arterial pressure, central venous pressure, blood gas tension showed no significant changes at these observed time intervals. Heart rate decreased 120 min after the start of the operation. Ethanol was detected in the expired breath 10 min after the start of the surgery, and showed progressive increase in concentration until the end of the surgery. Serum electrolyte concentrations and hemoglobin content showed gradual decrease proportional to the increase in irrigating fluid volume. The ethanol concentration in the expired breath was significantly correlated with the change in serum sodium concentration.(ABSTRACT TRUNCATED AT 250 WORDS)
对19例接受选择性经尿道前列腺良性增生切除术的患者(平均年龄70岁,范围58 - 80岁)进行了研究,这些患者在脊髓麻醉下手术(前列腺切除组织平均重量25 g,范围10 - 59 g;平均切除时间61分钟,范围45 - 80分钟),旨在通过呼出气体酒精分析早期检测灌洗液的吸收情况。所有手术中使用的灌洗液是稀释10倍的含1%乙醇的Urigal溶液。手术期间每10分钟将呼出气体收集到一个橡胶袋中,使用气体检测管(GASTEC LTD.)分析乙醇浓度。包括中心静脉压在内的血流动力学参数按相同间隔定期测量。每20分钟测量液体容量平衡。术前、切除术中相同的20分钟间隔以及手术结束后4 - 6小时采集血液。测量血清电解质、血红蛋白和总血浆蛋白浓度,并分析血气张力。在这些观察时间间隔内,平均动脉压、中心静脉压、血气张力均无显著变化。心率在手术开始后120分钟下降。手术开始后10分钟在呼出气体中检测到乙醇,且其浓度在手术结束前呈逐渐上升趋势。血清电解质浓度和血红蛋白含量随灌洗液体量的增加呈逐渐下降趋势。呼出气体中的乙醇浓度与血清钠浓度的变化显著相关。(摘要截短至250字)