<原著>〔第 II 篇〕人為的低血圧麻酔の臨床的意義(肺結核外科に於ける人為的低血圧麻酔に関する研究)

Abstract

Surgical Division of the Tuberculosis Research Institute, Kyoto University (Director : Prof. Chuzo NAGAISHI), and Kaizuka-sengokuso, National Sanatorium (Chief : Dr. Tetuo Jo). The effects of contolled hypotension by Hexamethonium on ventilatory and circulatory system were described, and adequate hypotension for heamodynamics and practical necessity was discussed. Moreover basing on clinical experiences of 115 cases, relative indication of controlled hypotension to the operation of pulmonary tuberculosis, was discussed. 1) Minute ventilation, o_2-consumption, o_2-contents in arterial and mixed venous blood, and o_2-saturation of arterial blood, were decreased considerably corresponding to remarkable fall of systemic maximum pressure, that was, when systemic sytolic pressure dropped below 80 mmHg. 2) By adequate oxygeneration, such change in blood were considerably recovered. 3) Not only systemic pressure, but also pulmonary and wedge pressure dropped most distinctly within five to ten minutes after injection of Hexamethonium, that would make the parenchymatous bleeding decrease in intrathoracic treatments. 4) Of all the hypotensive 115 cases, that were thoracoplasty, partial or segmental resection, lobectomy and decortication, bloodloss became smaller in lobectomy, but bleeding after operation showed a tendency to increase slightly. When controlled hypoten sion is applied, carefull control after operation would be required.