麻酔覚醒前後の酸素消費量と循環諸量の変動に対する硬膜外麻酔の効果
24例の開胸, 開腹手術患者で Swan-Ganz カテーテルを用いて, 全身麻酔覚醒時の酸素消費量 (VO2) や循環諸量に及ぼす硬膜外麻酔併用の効果を検討した. 硬膜外麻酔有効7例では, VO2をはじめ酸素運搬能 (DO2) などの変動は抑えられ, 血漿カテコラミン (CA) も低値であった. 一方, 硬膜外麻酔無効5例と, 全身麻酔のみの対照12例の諸量の変動は大きくVO2, DO2の著増, 混合静脈血酸素飽和度 (SVO2) の低下, 酸素摂取率 (O2ER) の増加, アシドーシスが認められCA値も上昇した. 従って, 麻酔覚醒時の諸量の変動は手術侵襲による疼痛と神経内分泌反応による...
Saved in:
| Published in | 日本臨床麻酔学会誌 Vol. 7; no. 6; pp. 516 - 524 |
|---|---|
| Main Authors | , , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
日本臨床麻酔学会
1987
|
| Online Access | Get full text |
| ISSN | 0285-4945 1349-9149 |
| DOI | 10.2199/jjsca.7.516 |
Cover
| Abstract | 24例の開胸, 開腹手術患者で Swan-Ganz カテーテルを用いて, 全身麻酔覚醒時の酸素消費量 (VO2) や循環諸量に及ぼす硬膜外麻酔併用の効果を検討した. 硬膜外麻酔有効7例では, VO2をはじめ酸素運搬能 (DO2) などの変動は抑えられ, 血漿カテコラミン (CA) も低値であった. 一方, 硬膜外麻酔無効5例と, 全身麻酔のみの対照12例の諸量の変動は大きくVO2, DO2の著増, 混合静脈血酸素飽和度 (SVO2) の低下, 酸素摂取率 (O2ER) の増加, アシドーシスが認められCA値も上昇した. 従って, 麻酔覚醒時の諸量の変動は手術侵襲による疼痛と神経内分泌反応によるCAの放出が重要な因子で, 硬膜外麻酔による求心路遮断が, 麻酔覚醒時の循環, 代謝の安定化に有利に働くと推定された. |
|---|---|
| AbstractList | 24例の開胸, 開腹手術患者で Swan-Ganz カテーテルを用いて, 全身麻酔覚醒時の酸素消費量 (VO2) や循環諸量に及ぼす硬膜外麻酔併用の効果を検討した. 硬膜外麻酔有効7例では, VO2をはじめ酸素運搬能 (DO2) などの変動は抑えられ, 血漿カテコラミン (CA) も低値であった. 一方, 硬膜外麻酔無効5例と, 全身麻酔のみの対照12例の諸量の変動は大きくVO2, DO2の著増, 混合静脈血酸素飽和度 (SVO2) の低下, 酸素摂取率 (O2ER) の増加, アシドーシスが認められCA値も上昇した. 従って, 麻酔覚醒時の諸量の変動は手術侵襲による疼痛と神経内分泌反応によるCAの放出が重要な因子で, 硬膜外麻酔による求心路遮断が, 麻酔覚醒時の循環, 代謝の安定化に有利に働くと推定された. |
| Author | 水野, 禎子 夏目, 長門 松浦, 正司 新井, 豊久 細田, 蓮子 下村, 啓 |
| Author_xml | – sequence: 1 fullname: 下村, 啓 organization: 藤田学園保健衛生大学医学部麻酔学教室 – sequence: 1 fullname: 夏目, 長門 organization: 藤田学園保健衛生大学医学部麻酔学教室 – sequence: 1 fullname: 松浦, 正司 organization: 藤田学園保健衛生大学医学部麻酔学教室 – sequence: 1 fullname: 水野, 禎子 organization: 藤田学園保健衛生大学医学部麻酔学教室 – sequence: 1 fullname: 新井, 豊久 organization: 藤田学園保健衛生大学医学部麻酔学教室 – sequence: 1 fullname: 細田, 蓮子 organization: 藤田学園保健衛生大学医学部麻酔学教室 |
| BookMark | eNo9kM1Kw0AcxBepYK09-Rypu8nm43-U4hcUvOg5bjZZbahVkl48Rmi1VhGKCkoRhSJipYqIVAt9mZA2eQu1FQ_DMMzwO8wsSpX3yg5C8wTnZAKw4Lo-Zzk9pxJtCqWJQkECQiGF0lg2VIkCVWdQ1veLFsYyNagCWhptJV_9pHoRP9wktWZUP4sGp2HQTaq90fvd8OM4fusnR-dh8BgNnkbN17jTG8du1K5Hjcsw6EQvgzC4Dg8bo_vnuNaK2lcT4O_m5HN425pD04KVfCf75xm0uby0kV-VCusra_nFguQSoFiyAQTDlnCwrRuMA3BOFKJyRyjcJrKg1LKoZQvuEGIrmGqGAI0KYhOGsaGCkkH5Cdf1K2zbMfe94i7zDkzmVYq85JjjdwgYxNRNbayfn_5bvsM802XKNyryhuw |
| ContentType | Journal Article |
| Copyright | 日本臨床麻酔学会 |
| Copyright_xml | – notice: 日本臨床麻酔学会 |
| DOI | 10.2199/jjsca.7.516 |
| DatabaseTitleList | |
| DeliveryMethod | fulltext_linktorsrc |
| EISSN | 1349-9149 |
| EndPage | 524 |
| ExternalDocumentID | article_jjsca1981_7_6_7_6_516_article_char_ja |
| GroupedDBID | ALMA_UNASSIGNED_HOLDINGS CS3 DIK JSF KQ8 OK1 RJT |
| ID | FETCH-LOGICAL-j1940-d99fa0bfe0d78ac99cc1315cef3cd12f44bb4bdfce11d30468f964f1d1a008593 |
| ISSN | 0285-4945 |
| IngestDate | Wed Sep 03 06:29:28 EDT 2025 |
| IsDoiOpenAccess | true |
| IsOpenAccess | true |
| IsPeerReviewed | false |
| IsScholarly | true |
| Issue | 6 |
| Language | Japanese |
| LinkModel | OpenURL |
| MergedId | FETCHMERGED-LOGICAL-j1940-d99fa0bfe0d78ac99cc1315cef3cd12f44bb4bdfce11d30468f964f1d1a008593 |
| OpenAccessLink | https://www.jstage.jst.go.jp/article/jjsca1981/7/6/7_6_516/_article/-char/ja |
| PageCount | 9 |
| ParticipantIDs | jstage_primary_article_jjsca1981_7_6_7_6_516_article_char_ja |
| PublicationCentury | 1900 |
| PublicationDate | 19870000 |
| PublicationDateYYYYMMDD | 1987-01-01 |
| PublicationDate_xml | – year: 1987 text: 19870000 |
| PublicationDecade | 1980 |
| PublicationTitle | 日本臨床麻酔学会誌 |
| PublicationTitleAlternate | 日臨麻会誌 |
| PublicationYear | 1987 |
| Publisher | 日本臨床麻酔学会 |
| Publisher_xml | – name: 日本臨床麻酔学会 |
| References | 13) Milson I, Forssman L, Biber B, et al.: Maternal haemodynamic changes during caesarean section: A comparison of epidural and general anaesthesia. Acta Anaesth. Scand. 29: 161-167, 1985 1) 細田蓮子, 松浦正司, 水野禎子ほか: 麻酔覚醒時の酸素消費量と循環諸量の変動について. 麻酔 36: 914～920, 1987 5) 尾山力: 麻酔および手術侵襲と内分泌機能. 麻酔 28: 459～465, 1979 9) Stefánson T, Wickström I, Haljamäe H, et al.: Effects of neurolept and epiural analgesia on cardiovascular function and tissue metabolism in the geriatric patient. Acta Anaesth. Scand. 26: 386-392, 1982 12) Hodgkinson R, Husain FJ, & Hayashi RH: Systemic and pulmonary blood pressure during caesarean section in parturients with gestational hypertension. Canad. Anaesth. Soc. J. 27: 389-394, 1980 6) Pflug AE & Halter JB: Effect of spinal anesthesia on adrenergic tone and the neuroendocrine responses to surgical stress in humans. Anesthesiology 55: 120-126, 1981 11) Gelman S, Laws HL, Potzick J, et al.: Thoracic epidural vs balanced anesthesia in morbid obesity: An intraoperative and postoperative hemodynamic study. Anesthesia and Analgesia 59: 902-908, 1980 2) 岡田和夫: 酸素欠乏の生体反応と適応. 臨床麻酔 8: 949～959, 1984 3) Halter JB, Pflug AE, Porte D: Mechanism of plasma catecholamine increase during surgical stress in man. J. Clin. Endocrin. Met. 45: 936-944, 1977 10) Ecoffery C, Edoward A, Pruszczynski W, et al.: Effects of epidural anesthesia on catecholamines, renin activity, and vasopressine changes induced by tilt in eldery men. Anesthesiology 62: 294-297, 1985 15) Stanley TH, Berman LB, Green O, et al.: Plasma catecholamine and cortisol responses to fentanyloxygen anesthesia for coronary-artery operations. Anesthesiology 53: 250-253, 1980 18) Hoar PF, Nelson NT, Mangano DT, et al.: Adrenergic response to morphine-diazepam anesthesia for myocardial revascularization. Anesthesia and Analgesia 60: 406-411, 1981 16) Tammisto T, Takki S, Nikki P, et al.: Effect of operative stress on plasma catecholamine levels during neuroleptanalgesia. Anaesthesist 22: 158-161, 1973 4) Traynor C, Hall GM: Endocrine and metabolic changes during surgery: Anesthetic implications. Br. J. Anaesth. 53: 153-160, 1981 7) Engquist A, Brandt MR, Fernandes A, et al.: The blocking effect of eqidural analgesia on the adrenocortical and hyperglycemic responses to surgery. Acta Anaesth. Scand. 21: 330-335, 1977 14) 村上雅子: 下腹部開腹術における内分泌•代謝反応-硬膜外麻酔法と全身麻酔法の影響-麻酔 36: 583～591, 1987 8) Madsen SN, Brandet MR, Engquist A, et al.: Inhibition of plasma cyclic AMP, glucose and cortisol response to surgery by epidural analgesia. Br. J. Surg. 64: 669-671, 1977 17) Balogh D, Hammerle AF, Hortnagl H, et al.: Plasma-Katecholamine bei Halothan-N2O-Anaesthesie und Neuroleptanalgesie. Intra-und postoperative Vergleichs-studie. Anaesthesist 28: 517-522, 1979 |
| References_xml | – reference: 1) 細田蓮子, 松浦正司, 水野禎子ほか: 麻酔覚醒時の酸素消費量と循環諸量の変動について. 麻酔 36: 914～920, 1987 – reference: 2) 岡田和夫: 酸素欠乏の生体反応と適応. 臨床麻酔 8: 949～959, 1984 – reference: 5) 尾山力: 麻酔および手術侵襲と内分泌機能. 麻酔 28: 459～465, 1979 – reference: 9) Stefánson T, Wickström I, Haljamäe H, et al.: Effects of neurolept and epiural analgesia on cardiovascular function and tissue metabolism in the geriatric patient. Acta Anaesth. Scand. 26: 386-392, 1982 – reference: 7) Engquist A, Brandt MR, Fernandes A, et al.: The blocking effect of eqidural analgesia on the adrenocortical and hyperglycemic responses to surgery. Acta Anaesth. Scand. 21: 330-335, 1977 – reference: 16) Tammisto T, Takki S, Nikki P, et al.: Effect of operative stress on plasma catecholamine levels during neuroleptanalgesia. Anaesthesist 22: 158-161, 1973 – reference: 3) Halter JB, Pflug AE, Porte D: Mechanism of plasma catecholamine increase during surgical stress in man. J. Clin. Endocrin. Met. 45: 936-944, 1977 – reference: 4) Traynor C, Hall GM: Endocrine and metabolic changes during surgery: Anesthetic implications. Br. J. Anaesth. 53: 153-160, 1981 – reference: 15) Stanley TH, Berman LB, Green O, et al.: Plasma catecholamine and cortisol responses to fentanyloxygen anesthesia for coronary-artery operations. Anesthesiology 53: 250-253, 1980 – reference: 14) 村上雅子: 下腹部開腹術における内分泌•代謝反応-硬膜外麻酔法と全身麻酔法の影響-麻酔 36: 583～591, 1987 – reference: 8) Madsen SN, Brandet MR, Engquist A, et al.: Inhibition of plasma cyclic AMP, glucose and cortisol response to surgery by epidural analgesia. Br. J. Surg. 64: 669-671, 1977 – reference: 17) Balogh D, Hammerle AF, Hortnagl H, et al.: Plasma-Katecholamine bei Halothan-N2O-Anaesthesie und Neuroleptanalgesie. Intra-und postoperative Vergleichs-studie. Anaesthesist 28: 517-522, 1979 – reference: 10) Ecoffery C, Edoward A, Pruszczynski W, et al.: Effects of epidural anesthesia on catecholamines, renin activity, and vasopressine changes induced by tilt in eldery men. Anesthesiology 62: 294-297, 1985 – reference: 11) Gelman S, Laws HL, Potzick J, et al.: Thoracic epidural vs balanced anesthesia in morbid obesity: An intraoperative and postoperative hemodynamic study. Anesthesia and Analgesia 59: 902-908, 1980 – reference: 6) Pflug AE & Halter JB: Effect of spinal anesthesia on adrenergic tone and the neuroendocrine responses to surgical stress in humans. Anesthesiology 55: 120-126, 1981 – reference: 13) Milson I, Forssman L, Biber B, et al.: Maternal haemodynamic changes during caesarean section: A comparison of epidural and general anaesthesia. Acta Anaesth. Scand. 29: 161-167, 1985 – reference: 12) Hodgkinson R, Husain FJ, & Hayashi RH: Systemic and pulmonary blood pressure during caesarean section in parturients with gestational hypertension. Canad. Anaesth. Soc. J. 27: 389-394, 1980 – reference: 18) Hoar PF, Nelson NT, Mangano DT, et al.: Adrenergic response to morphine-diazepam anesthesia for myocardial revascularization. Anesthesia and Analgesia 60: 406-411, 1981 |
| SSID | ssib002484396 ssj0036822 |
| Score | 1.3121715 |
| Snippet | 24例の開胸, 開腹手術患者で Swan-Ganz カテーテルを用いて, 全身麻酔覚醒時の酸素消費量 (VO2) や循環諸量に及ぼす硬膜外麻酔併用の効果を検討した. 硬膜外麻酔有効7例では, VO2をはじめ酸素運搬能 (DO2) などの変動は抑えられ, 血漿カテコラミン (CA) も低値であった. 一方,... |
| SourceID | jstage |
| SourceType | Publisher |
| StartPage | 516 |
| Title | 麻酔覚醒前後の酸素消費量と循環諸量の変動に対する硬膜外麻酔の効果 |
| URI | https://www.jstage.jst.go.jp/article/jjsca1981/7/6/7_6_516/_article/-char/ja |
| Volume | 7 |
| hasFullText | 1 |
| inHoldings | 1 |
| isFullTextHit | |
| isPrint | |
| ispartofPNX | 日本臨床麻酔学会誌, 1987/11/15, Vol.7(6), pp.516-524 |
| link | http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwrV3Na9RAFA-lXryIouI3PXSOWfMxycyAl8w2S1EUhBZ6i0k2OeyhirYXbyu0WqsIRQWliEIRsVJFRKqF_jNL2t3_wvdmkm0sPVj1sGF25r3fvI9N3pvZmYlhjCc-i92MchOCMQ5QvNxMaNo2BU2ZcJIky9R2ses3_MlpenXGmxkZHa-tWpqfSxrp_QP3lfyNV6EO_Iq7ZA_h2SEoVEAZ_AtX8DBc_8jHJBREBkRKLHCPCEpCTgKfiEDVQMEhoUc4lCewIEPCmyR0IX8kQVhySU5CRiQlgUVCn0ifcI440qmQGeGtiouXOEGAXIAvLdWpVDj7iEMkDigKgGJIIryqSaqmFkLpGiFUwUEyQA6AponIqEWzxBH-QSrX-uLQJFALEQJXPfNWlQDrqUKzAmeVRgHyHgAO_U6gSUNKZFMZlqPufDi7rFq4khqAJ4iw8WeLjKCscPfItCVaymwS5VVkAskkUwWwvLVHr9DQPOATD0VQ9L6Sx1XKgvV4nR5cAW4snVDiM-TkYamIfmmqnubBiaDhLfm_zFMLLA73TCr0MZ6NTAc-lwoIfPr42CoystoDoB7lPNuvJUye3gS_PxZDKMSjbDude2ncYI0hz2-Hm5e3TqSoQG07YpGvPkAfVa24ATHqwCjoiMOYjQt3r92sD5o5ZNV-lX-5Ptf_HVZa6l25KM7lmjCQcXZg_FWt3VTp5NRx41g5DhwLdN8njJFs9qRxa_Bza7DwvP_-9WBxpVh6Wmw_6XU3Bgubu9_e7nx_1P-6NXj4rNf9UGx_3F350l_fVF83irWlYvlFr7tefN7udV_1HizvvvvUX1wt1l5qQKR5_GPnzeopY7oVTjUnzfIVKGbHFtQy20LksZXkmdVmPE6FSFPbtb00y920bTs5pUlCk3aeZrbdxkUOPBc-ze22HVvqKMPTxujs7dnsjDHmxHFiZSIVsRA4jIsT7nEGz_DEynOL0rPGFW2Q6I4-5yY6lHPO_Rv7eeMo_ur15OYFY3Tu7nx2EdL9ueSS8vYv3PzZNA |
| linkProvider | Colorado Alliance of Research Libraries |
| openUrl | ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=%E9%BA%BB%E9%85%94%E8%A6%9A%E9%86%92%E5%89%8D%E5%BE%8C%E3%81%AE%E9%85%B8%E7%B4%A0%E6%B6%88%E8%B2%BB%E9%87%8F%E3%81%A8%E5%BE%AA%E7%92%B0%E8%AB%B8%E9%87%8F%E3%81%AE%E5%A4%89%E5%8B%95%E3%81%AB%E5%AF%BE%E3%81%99%E3%82%8B%E7%A1%AC%E8%86%9C%E5%A4%96%E9%BA%BB%E9%85%94%E3%81%AE%E5%8A%B9%E6%9E%9C&rft.jtitle=%E6%97%A5%E6%9C%AC%E8%87%A8%E5%BA%8A%E9%BA%BB%E9%85%94%E5%AD%A6%E4%BC%9A%E8%AA%8C&rft.au=%E4%B8%8B%E6%9D%91%2C+%E5%95%93&rft.au=%E5%A4%8F%E7%9B%AE%2C+%E9%95%B7%E9%96%80&rft.au=%E6%9D%BE%E6%B5%A6%2C+%E6%AD%A3%E5%8F%B8&rft.au=%E6%B0%B4%E9%87%8E%2C+%E7%A6%8E%E5%AD%90&rft.date=1987&rft.pub=%E6%97%A5%E6%9C%AC%E8%87%A8%E5%BA%8A%E9%BA%BB%E9%85%94%E5%AD%A6%E4%BC%9A&rft.issn=0285-4945&rft.eissn=1349-9149&rft.volume=7&rft.issue=6&rft.spage=516&rft.epage=524&rft_id=info:doi/10.2199%2Fjjsca.7.516&rft.externalDocID=article_jjsca1981_7_6_7_6_516_article_char_ja |
| thumbnail_l | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=0285-4945&client=summon |
| thumbnail_m | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=0285-4945&client=summon |
| thumbnail_s | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=0285-4945&client=summon |