Cyclopropane 및 Fluothane 마취가 출혈성쇽크견의 혈력학에 미치는 영향-비교적 연구

• Published in: Korean journal of anesthesiology Vol. 5; no. 2; pp. 1 - 8
• Main Authors: 김광우, Kwang Woo Kim, 곽일용, II Yong Kwak, 김용락, Yong Lack Kim
• Format: Journal Article
• Language: Korean
• Published: 대한마취통증의학회(구 대한마취과학회) 30.12.1972
• ISSN: 2005-6419; 2005-7563

In order to comparatively evaluate the effects of cyclopropane and fluothane upon mean arterial pressure. cardiac output and splanchnic blood flow during hemorrhagic shock a Iaboratory investigation was conducted in the following three successive phases in two groups: Group I (cyclopropane):1l. Observation 60 minutes following Nembutal I .V. injection 2. Observation 30 minutes following acute hemorrhage 3. Observation 30 minutes following cyclopropane anesthesia Group II (fluothane): 1. Observation 60 minutes following Nembutal I .V. injection 2. Observation 30 minutes following acute hemorrhage 3. Observation 30 minutes following fluothane anesthesia Nine mongrel dogs weighing 11.2±1. 2kg composed each group. Immediately following induction of anesthesia with intravenous pentobarbital (Nembutal), all dogs were endotracheally intubated with the aid of intravenous succinylcholine chloride. Spontaneous respiration was allowed during pentobarbital anesthesia, but ventilation was controlled with Ohio Anesthesia Ventilator during cyclopropane or fluothane anesthesia. In order to insure the adepuacy of ventilation, arterial blood samples were drawn at appropriate intervals for analysis of pH and Pco₂ by Beckman Blood Gas Measurement System. Ventilation was adjusted so that the pH and Pco₂ were maintained in the range of 7.30~7.35 and 30~35 mmHg. A heating pad was used to maintain the esophageal temperature at the normal leveal (±0.5°C.). The internal carotid artery and femoral vein were cannulated. Carotid arterial pressure was measured by sensing with a Statham transducer. Lead II of the electrocardiograph and arterial presaure were continuously monitored end recorded on the Beckman RM 4-Channel Monitor/Recorder. The abdomen was opened and the portal vein and common hepatic artery were cannulated with IVM FT-P Blood Flow Transducer and the blood flow was recorded on EMF-120 Electromagnetic Blood Flowmeter. Bleeding amounted to approximately 2per cent of the body weight. Cardiac output was measured by the direct Fick method. Cyclopropane was administered in the concentration of 10 per cent(100cc/min cyclopropane-900cc/min oxygen) and fluothane-was administered in 1 per cent concentration from Mark II Fluotec vaporizer. Both anesthetics were delivered in semiclosed circle carbon dioxide absorption system. The results are summarized in Tables 1~2. In brief both cyclopropane and fluothane caused a further reduction in splanchnic blood flow by 14 per cent and 21 per cent respectively during hemorrhagic hypotension. Mean arterial pressure rose 24 per cent and cardiac output increased 17 per cent by cyclopropane, whereas mean arterial pressure fell 25 per eent and cardiac output decreased 24 per eent by fluothane. Furthermore, five out of nine dogs inhaled fluothane did not survive despite retransfusion after the experiment. All changes were conaistent and atatistically significant (P<0. 001). The reults suggest that for patients with hypovolemie hypotension without blood replacement cyclo- propane would be the inhalation anesthetic of choice, fluothane might be detrimental in such circum-stances, and that the choice of fluothane ahould be reserved for normovolemic vasnconatrictive states.