ニトログリセリン低血圧麻酔に対するジルチアゼム併用の心血管系に及ぼす効果

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タイトル別名
  • Combination of Nitroglycerine and Diltiazem on Hemodynamics for Induced Hypotension during Enflurane/N2O Anesthesia.

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The hemodynamic effects of diltiazem and nitroglycerine during enflurane/N2O anesthesia were evaluated in 17 patients who required deliberate hypotension for major gynecological procedures. Subjects were randomly assigned to receive nitroglycerine alone (group A), combined with diltiazem at 2μg/kg/min (group B), or 5μg/kg/min (group C). Systolic blood pressure decreased significantly and was maintained at 90mmHg level in all groups. Onset of hypotension was faster in group B and C. Heart rate increased in group A and B, but decreased significantly in group C. Cardiac output did not differ from prehypotensive values in group A and B. Central venous pressure and pulmonary capillary wedge pressure decreased in all groups. In group C, cardiac output decreased associated with unchaging systemic vascular resistance. Systolic blood pressure increased after the end of infusion in all groups. The dosage of nitroglycerine required to maintain hypotension was greatly reduced in a dose-dependent fashion by administration of diltiazem.<br>These data suggest that the combination of diltiazem at 2μg/kg/min and nitroglycerine is a useful and safe method for inducing hypotension during enflurane anesthesia.

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