Chassard D, Tournadre J P, Berrada K R, Bryssine B, Bouletreau P
Service d'Anesthésie-Réanimation, Hôpital de l'Hôtel-Dieu, Lyon, France.
Br J Anaesth. 1996 Dec;77(6):781-3. doi: 10.1093/bja/77.6.781.
We have studied the effects of volatile anaesthetics on lower oesophageal sphincter (LOS) tone in three groups of eight pigs allocated randomly to receive end-tidal concentrations of 0.5, 1.0 and 1.5 MAC of desflurane, isoflurane or halothane for 15 min. LOS and oesophageal barrier pressures (BrP = LOSP - gastric pressure) were measured using a manometric method. The decrease in BrP paralleled the decrease in LOS pressure and was significant at 0.5 MAC for isoflurane and at 1.0 MAC for halothane. At 1.5 MAC, BrP values were approximately 62% of baseline values for halothane, 37% for isoflurane and 83% for desflurane. Inter-group comparisons showed that BrP did not differ at baseline and at 0.5 MAC. At 1.0 MAC the effect of isoflurane on BrP was significantly different from desflurane (P < 0.001) and halothane (P < 0.02) whereas the effect of desflurane on BrP was not significantly different from halothane. At 1.5 MAC the effect of isoflurane on BrP was significantly different from desflurane (P < 0.01) and halothane (P < 0.05) whereas the effect of desflurane on BrP was not significantly different from halothane. We conclude that desflurane maintained BrP and this may be clinically important in patients at high risk of regurgitation.
我们将24只猪随机分为三组，每组8只，分别给予呼气末浓度为0.5、1.0和1.5倍最低肺泡有效浓度（MAC）的地氟烷、异氟烷或氟烷，持续15分钟，研究了挥发性麻醉剂对猪下食管括约肌（LOS）张力的影响。采用测压法测量LOS和食管屏障压（BrP = LOS压力 - 胃内压力）。BrP的降低与LOS压力的降低平行，异氟烷在0.5 MAC时、氟烷在1.0 MAC时BrP降低显著。在1.5 MAC时，氟烷的BrP值约为基线值的62%，异氟烷为37%，地氟烷为83%。组间比较显示，基线时和0.5 MAC时BrP无差异。在1.0 MAC时，异氟烷对BrP的影响与地氟烷（P < 0.001）和氟烷（P < 0.02）显著不同，而地氟烷对BrP的影响与氟烷无显著差异。在1.5 MAC时，异氟烷对BrP的影响与地氟烷（P < 0.01）和氟烷（P < 0.05）显著不同，而地氟烷对BrP的影响与氟烷无显著差异。我们得出结论，地氟烷可维持BrP，这对反流高危患者可能具有重要临床意义。
