Kanaya N, Nakayama M, Fujita S, Namiki A
Department of Anesthesiology, School of Medicine, Sapporo Medical University, Japan.
Br J Anaesth. 1995 Feb;74(2):164-7. doi: 10.1093/bja/74.2.164.
We have examined the effects of inhalation anaesthetics on indocyanine green (ICG) clearance, as an index of hepatic function, in patients undergoing elective surgery. Recently, a new method has been developed to measure in real-time the disappearance rate of ICG from plasma. This method eliminates the multiple sampling and delay of the conventional ICG test. ICG clearance is displayed as two indices: K (ICG disappearance rate) and R15 (ICG retention rate 15 min after injection of ICG 0.5 mg kg-1). This measurement was performed in patients before and after 1 MAC of sevoflurane (n = 6), 2 MAC of sevoflurane (n = 6), 1 MAC of isoflurane (n = 6), 2 MAC of isoflurane (n = 6), 1 MAC of halothane (n = 6) or 2 MAC of halothane (n = 6) without surgical stress. Although mean arterial pressure decreased significantly at 1 and 2 MAC of sevoflurane, 2 MAC of halothane, and 1 and 2 MAC of isoflurane, ICG clearance was maintained at awake levels, except at 2 MAC of halothane (K = mean-33 (sem 3)%, R15 = +90 (3)% from awake values). We conclude that sevoflurane and isoflurane have a more favourable effect on liver circulation than halothane.
我们研究了吸入麻醉药对接受择期手术患者肝功能指标——吲哚菁绿（ICG）清除率的影响。最近，已开发出一种新方法来实时测量ICG从血浆中的消失率。该方法消除了传统ICG试验中的多次采样和延迟。ICG清除率以两个指标表示：K（ICG消失率）和R15（注射0.5mg/kg ICG后15分钟时的ICG潴留率）。在无手术应激情况下，对接受1个最低肺泡有效浓度（MAC）七氟醚（n = 6）、2个MAC七氟醚（n = 6）、1个MAC异氟醚（n = 6）、2个MAC异氟醚（n = 6）、1个MAC氟烷（n = 6）或2个MAC氟烷（n = 6）的患者进行了此项测量。尽管在1和2个MAC七氟醚、2个MAC氟烷以及1和2个MAC异氟醚时平均动脉压显著降低，但除2个MAC氟烷外（K = 较清醒值平均降低-33（标准误3）%，R15 = 较清醒值升高+90（3）%），ICG清除率维持在清醒水平。我们得出结论，七氟醚和异氟醚对肝循环的影响比氟烷更有利。
