術中低圧系循環動態変化に関する基礎的ならびに臨床的研究

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From the standpoint of venous return mechanism which Guyton, Hori and Muteki interpreted, in the present study cardiodynamic equilibrium of the cardiovascular function was fundamentally and clinically investigated, and the clinical significance of monitoring its functional equilibrium point during general anesthesia of surgery was studied. Cardiodynamic equilibrium point of the cardiovascular function was indicated as the apex point of the triangle with cardiac function curve (C.O.) on the left side and venous return curve (V.R.) on the right side in the correlation diagram between cardiac output or venous return of ordinate and venous pressure of abscissa. Gco was indicated as the angle (tanα) between the left side of triangle and the perpendicular line, and represented venous return resistance to the left ventricle. G_<VR> was the angle (tanβ) between the right side of triangle and the perpendicular line, and indicated venous return resistance to the right ventricle (R.V.). The present study was designed to investigate changes of G_<CO> and G_<VR> obtained from before induction of anesthesia, during maintenance and at the time of epinephrine injection in 25 cases of operations under general anesthesia. These patients without cardiovascular complication were from 16 to 62 years old and weighed from 42 to 82 kg. The study was further conducted on specific conditions of hemodynamic changes in hypervolemia, hypovolmia, L.V. function reduce and R.V. function reduce in the same operations. Cardiovascular equilibrium point in correlation diagram between C.O. or V.R. and venous pressure was recognized to shift to the identified directions after induction of anesthesia, during maintenance of anesthesia and at the time of epinephrine injection and as specific conditions of hemodynamic changes respectively. Furthermore, in order to study influence of various ventilation methods, changes of hemodynamics and injection of epinephrine and octapressin on cardiodynamic function of right atrium as low pressure system, CVP wave form of 32 dogs, weighing 8 to 14 kg, was analysed by fast fourier transform (FFT) and changes of frequency power spectrum pattern and amplitude of CVP wave form were investigated. Characteristic patterns of the frequency power spectrum pattern and amplitude in CVP wave form were identified, depending on fundamental frequency (pulse rate/60) of the CVP wave form and change of intrathoracic pressure, venous return flow and position of the equilibrium point on the hemodynamic diagram. Epinephrine injection caused an increase of the amplitude as its dose was increased, but octapressine injection did not.
九州歯科学会の論文
1986-04-25

著者

門脇啓治
九州歯科大学歯科麻酔学講座:久留米大学医学部麻酔学講座:九州歯科大学大学院歯学研究科

術中低圧系循環動態変化に関する基礎的ならびに臨床的研究

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