Search

プロポフォールの制吐作用を検討するために,亜酸化窒素・酸素と硬膜外麻酔併用下で腹腔鏡下胆嚢摘出術を行った150例を対象にして嘔気と嘔吐の発生率を比較した.麻酔の導入にチオペンタール6mg・kg-1を用いた群(T群),プロポフォール3mg・kg-1を用いた群(P1群),プロポフォール2mg・kg-1で導入後,手術終了まで5mg・kg-1・h-1で持続投与した群(P2群)の3群に分け,いずれも酸素・亜酸化窒素・ベクロニウム・硬膜外麻酔で維持した.術後24時間の嘔気発生率はT群で50%,P1群で3296,P2群で40%と3群間に有意差を認めなかつた,嘔吐発生率,制吐薬使用率も差はなく,5mg・kg-1・h-1のプロポフォール持続投与では効果的な制吐作用がないと考えられた.

To compare the in vivo and in vitro pharmacokinetics of succinylcholine (SCh) in humans.A bolus of SCh 1 mg.kg(-1) (n = 7) or 2 mg.kg(-1) (n = 11) was given to 18 patients anesthetized with thiopental. Arterial blood samples for determination of in vivo SCh concentrations were collected every 30 s for 5 min. Another 20-ml blood sample was obtained before induction of anesthesia for determination of in vitro SCh. Concentrations of SCh were measured by high-performance liquid chromatography. In vivo and in vitro concentrations of SCh vs time data were analyzed by the one-compartment model.The respective in vivo and in vitro pharmacokinetic parameters (SCh 1 mg.kg(-1) vs SCh 2 mg.kg(-1)) were as follows: Plasma clearance was 4.17 +/- 2.37 and 1.85 +/- 0.28 l.min(-1), P0.05, vs 2.91 +/- 2.01 and 1.27 +/- 0.43 l.min(-1), P0.05. Elimination half-life was 25.4 +/- 10.6 and 47.4 +/- 5.4 s, P0.002 vs 26.3 +/- 10.0 and 75.2 +/- 21.8 s, P0.00005.These results suggest that the rapid disappearance of SCh from the circulation is due to diffusion out of the blood vessels rather than to enzymatic hydrolysis.

砕石位婦人科手術343例を対象とし,硬膜外麻酔併用全身麻酔後の大腿神経麻痺発生率を検討し,11例(3%)に認めた.硬膜外カテーテル造影と臨床症状より,硬膜外麻酔の影響は小さいと思われた.一方,平坦な砕石位により鼠径靱帯が過度に伸展した体位では8例(5%)に発生したが,過伸展しない体位に変更後3例(2%)と有意(p