用于评估氟烷和异氟烷麻醉期间肝血流的无创吲哚菁绿清除试验。

Noninvasive ICG clearance test for estimating hepatic blood flow during halothane and isoflurane anaesthesia.

作者信息

Kanaya N, Iwasaki H, Namiki A

机构信息

Department of Anesthesiology, School of Medicine, Sapporo Medical University, Japan.

出版信息

Can J Anaesth. 1995 Mar;42(3):209-12. doi: 10.1007/BF03010678.

DOI:10.1007/BF03010678

PMID:7743571

Abstract

The purpose of this study was to estimate hepatic blood flow during halothane (HAL) or isoflurane (ISO) anaesthesia with the noninvasive indocyanine green (ICG) clearance test. Twenty-four ASA status I adult patients, scheduled for elective surgery without liver disease, were allocated into four groups. Before surgery, ICG clearance was measured twice in patients before and after 1, 2 MAC HAL-N2O, 1 and 2 MAC ISO-N2O anaesthesia by ICG clearance meter (Sumitomo Electronics, Japan). This method eliminates the blood sampling and delay of the conventional ICG test. The ICG clearance is displayed in two indices: K (ICG disappearance rate) and R15 (ICG retention rate 15 min after 0.5 mg.kg-1 ICG injection). Indirect blood pressure and heart rate were measured simultaneously. Mean arterial pressure (MAP) decreased by 27, 22 and 29% with 2 MAC HAL-N2O, and with 1 and 2 MAC ISO-N2O groups, respectively (P < 0.05). The ICG clearance was less (P < 0.05) in the 2 MAC HAL-N2O group (K, 0.087 min-1) than with either awake (K, 0.131 min-1) or other groups (K, 0.114 and 0.144 min-1, in the 1 MAC HAL and ISO-N2O groups, respectively) in spite of a similar degree of the depletion of MAP in 2 MAC ISO-N2O group (K, 0.124 min-1). We conclude that isoflurane has a more favourable effect on liver circulation than does halothane.

摘要

本研究旨在通过无创吲哚菁绿（ICG）清除试验评估氟烷（HAL）或异氟烷（ISO）麻醉期间的肝血流量。24例拟行择期手术且无肝脏疾病的ASA I级成年患者被分为四组。手术前，使用ICG清除仪（日本住友电子）在患者清醒状态下以及1、2MAC HAL-N₂O、1和2MAC ISO-N₂O麻醉前后两次测量ICG清除率。该方法消除了传统ICG试验中的采血和延迟。ICG清除率以两个指标显示：K（ICG消失率）和R15（0.5mg·kg⁻¹ICG注射后15分钟的ICG潴留率）。同时测量间接血压和心率。平均动脉压（MAP）在2MAC HAL-N₂O组、1MAC和2MAC ISO-N₂O组分别下降了27%、22%和29%（P<0.05）。2MAC HAL-N₂O组的ICG清除率较低（P<0.05）（K，0.087min⁻¹），尽管2MAC ISO-N₂O组的MAP下降程度相似（K，0.124min⁻¹），但仍低于清醒状态（K，0.131min⁻¹）或其他组（1MAC HAL和ISO-N₂O组的K分别为0.114和0.144min⁻¹）。我们得出结论，异氟烷对肝脏循环的影响比氟烷更有利。