耳部手术全麻药物对肾功能影响的观察。

R Szulc
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引用次数: 0

摘要

本研究的目的是:1)观察阿托品和哌替啶在用药前静脉给药对肾脏的影响,2)评估乙醚和氟烷对肾脏的影响,3)研究呼吸对全身麻醉时肾功能的影响,4)评估麻醉时用于手术野浸润的奥他普利辛的抗利尿作用。对27例患者进行了用药前药物对肾脏的影响研究。将20例患者分为两组,观察全麻和手术对肾功能的影响。第一组采用乙醚麻醉,第二组采用氟烷麻醉。在两组中,根据全麻期间应用的呼吸类型分离A和B亚组(A亚组-人工辅助呼吸,B亚组-自发呼吸)。ⅰ组和ⅱ组患者均应用奥他ressin进行手术野浸润。采用氟烷麻醉并人工辅助呼吸的5例(II-A亚组)患者的肾功能测定结果评价氟烷对肾脏的影响。这些结果与III组比较,III组由5例氟烷麻醉的患者组成,他们没有给予奥他ressin浸润。从这些结果可以得出以下结论:1)静脉注射治疗剂量的阿托品和哌啶可显著减少肾小球滤过。2)全麻和手术期间肾功能的改变是ADH分泌刺激和肾血流动力学改变的结果。3)乙醚和氟烷对肾脏的影响没有差异,这可能是由于机体内调节肾脏循环和渗透平衡的代偿性肾脏机制。4)麻醉期间不同通气方式对肾脏的影响也无差异。5)术野浸润治疗剂量的奥他普利素对全身麻醉药的抗利尿作用无增强作用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Observations on the effects of drugs used in general anaesthesia for ear operations on renal functions.

The purpose of this study was: 1) to observe the renal effects of atropine and pethidine administered intravenously in premedication, 2) to assess the renal effects of diethyl ether and halothane, 3) to study the effects of respiration on the renal functions in general anaesthesia and 4) to evaluate the antidiuretic action of Octapressin used for infiltration of the field of operation during anaesthesia. The studies on the renal effects of the drugs used in premedication were carried out on 27 patients. The renal effects of general anaesthesia and operation on renal functions were studied in 20 patients divided into 2 groups. Group I comprised of patients under diethyl ether anaesthesia while in group II halothane was used. In both groups subgroups A and B were isolated depending on the type of respiration applied during general anaesthesia (subgroup A -- manually assisted respiration, subgroup B -- spontaneous respiration). In all patients in groups I and II Octapressin was used for infiltration of the field of operation. Its renal effects were assessed on the results of determinations in 5 cases (subgroup II-A) anaesthetized with halothane and receiving manually assisted respiration. These results were compared with those in group III which comprised of 5 patients anaesthetized with halothane who were not given Octapressin infiltrations. The following conclusions have been drawn from these results: 1) Atropine and pethidine administered intravenously in therapeutic doses significantly reduce glomerular filtration. 2) Changes in renal functions observed during general anaesthesia and operation were the result of ADH secretion stimulation and changes in renal haemodynamics. 3) No differences were observed between the renal effects of diethyl ether and halothane which was due, probably, to compensatory renal mechanisms regulating renal circulation and osmotic equilibrium in the organism. 4) No differences were observed also in the renal effects of various method of ventilation used during anaesthesia. 5) Octapressin used in therapeutic doses for infiltration of the operation field had no potentiating effect on the antidiuretic action of general anaesthetic agents.

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