<原著>全身麻酔下アナフィラキシー・ショックに関する実験的研究
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概要
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この論文は国立情報学研究所の学術雑誌公開支援事業により電子化されました。There are many reports including Besredka's that general anesthesia suppresses anaphylactic shock. However, it can not be concluded that this is so, because some other doctors reported quite opposite results. Recently, in the clinical field, importance is being placed on anaphylactic shock by penicillin. As a counter-drug for anaphylactic shock, adrenal cortical hormone, antihistamine substances, autonomic nerve blockers, angiotonin and coronary dilators are used. In addition to these, general anesthesia is also thought useful. According to clinical experiences, it was reported that during general anesthesia, penicillin and other drugs do not cause any anaphylactic shock. It was also reported that even in the transfusion of different blood groups, no severe shock was seen, if it was done during general anesthesia. Here researcher have made a basic investigation to find out whether or not general anesthesia really suppresses anaphylactic shock. Results obtained were as follows : 1) In passive sensitized guinea pigs with anti BAS serum from rabbits, ether anesthesia surely prevented anaphylactic shock by BSA. 2) Death by anaphylactic shock was not prevented either by general anesthesia using laughing gas and succinylcholin, or by the administration of morphine, atropine, tetraethylammonium or chlorpromazine. Especially in general anesthesia by laughing gas or succinylcholin, even when respiration was controlled, the animal died of acute collapse of the lungs after the administration of antigen. 3) In active sensitized guinea pigs and rabbits with BSA, the suppressive effect of ether anesthesia for anaphylactic shock was weak in guinea pigs, and was weaker in rabbits. 4) We knew from the above data, the suppressive effect of ether anesthesia depended on the amount of antibody in the experimental animal and on the animal species. 5) After anaphylactic shock, the antibody decreased naturally. Especially in the passive sensitized animal, it almost disappeared. However, in the active sensitized rabbits, reproduction of the antibody began shortly after the shock, and in 8 days it returned to the same amount as before the operation or more. Large amounts of antigen were given to be rabbits who escaped from death by shock to cause immunological paralysis. However, this ended unsuccessful at least in rabbits. 6) Using I^<131> labelled BSA, the site of antigen-antibody reaction was investigated and under ether anesthesia, the gathering of antigen in the lung or in the heart, which was found in the control group, was not seen. 7) Mechanisms of suppressive effects of ether anesthesia for anaphylactic shock were that : A) Ether acted on smooth muscles of the bronchi and made it dilate to antagonize against the constriction caused by anaphylactic shock; B) Ether acted on the coronary artery, making a higher efficiency of the heart function : C) Ether dilated peripheral blood vessels and prevented antigen from gathering in the central organs. 8) Even in the case where shock was suppressed by ether anesthesia and the patient escaped from death, pathohistologically it is common to leave in the liver necrosis resulting from antigen-antibody reaction. From this point of view, it seems necessary to pay attention to the disturbance of hepatic function as an after-effect of ether anesthesia as a countermeasure for anaphylactic shock.
- 京都大学の論文
- 1971-03-31