Shibata Y, Kukita I, Baba T, Goto T, Yoshinaga T
Department of Anesthesiology, Kumamoto Chuo Hospital.
Masui. 1993 Jan;42(1):116-9.
In cases of life-threatening status asthmaticus which are refractory to drug therapy, the administration of inhalation anesthetics can be life-saving as they help alleviate bronchial spasm. We had an 11-year-old female patient suffering from status asthmaticus who was moribund from severe CO2 narcosis and was not responding to any of the conventional therapies. She finally fell into ventricular fibrillation. After cardiopulmonary resuscitation, we administered 2.0% isoflurane in oxygen. Within half an hour, her high inspiratory pressure was dramatically decreased, and then the isoflurane concentration was maintained at 1.0%. After 14 hours of isoflurane anesthesia, PaCO2 decreased to the normal level and the isoflurane treatment was discontinued. The endotracheal tube was removed 4 hours later. She had an uneventful recovery and was discharged from the hospital 11 days later. With its low metabolic rate and therefore low organ toxicity, as well as its low arrhythmogenicity with remarkable bronchodilating activity, we feel isoflurane may well be superior to other inhalation anesthetics in the treatment of status asthmaticus.
在药物治疗无效的危及生命的哮喘持续状态病例中,吸入麻醉剂的使用可挽救生命,因为它们有助于缓解支气管痉挛。我们有一名11岁的女性哮喘持续状态患者,因严重的二氧化碳麻醉而奄奄一息,对任何传统治疗均无反应。她最终陷入心室颤动。心肺复苏后,我们在氧气中给予2.0%的异氟烷。半小时内,她的高吸气压力显著降低,然后异氟烷浓度维持在1.0%。异氟烷麻醉14小时后,动脉血二氧化碳分压降至正常水平,异氟烷治疗停止。4小时后拔除气管插管。她恢复顺利,11天后出院。由于其代谢率低,因此器官毒性低,以及其致心律失常性低且具有显著的支气管扩张活性,我们认为异氟烷在治疗哮喘持续状态方面可能优于其他吸入麻醉剂。