緊急時におけるエピネフリンの鼻腔内投与と舌内投与の効果

紧急情况下鼻内和舌内给予肾上腺素的效果

• 批准号: 09771809
• 负责人: 奥村 友季子
• 金额: $ 1.02万
• 依托单位: Aichi Gakuin University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Encouragement of Young Scientists (A)
• 财政年份: 1997
• 资助国家: 日本
• 起止时间: 1997 至 无数据
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-09771809/
• 关键词: 緊急; エピネフリン; 鼻腔内投与; 舌内投与; 血中濃度

緊急時には薬物投与は一般的に静脈内投与である.しかし,歯科治療をはじめ一次医療では技術,設備が必要であり静脈内投与を迅速に行うことは難しい.これに対し鼻腔内投与は経験は必要なく,鼻粘膜には血管が豊富で薬物吸収が速いと考えられる.一方,舌にも同様に血管が豊富で口腔の入り口にあるため操作しやすく,技術,設備は必要でなく,これも緊急時の薬物投与経路として期待できると考えている.今回は,イヌを用いた全身麻酔下で低血圧状態にし,エピネフリンを鼻腔内と舌に投与して血中濃度を測定し両者を比較検討した.ビ-グル犬にイソゾールで導入し,血管内挿管を行い笑気・酸素・イソフルランで維持し,ニトログリセリンを静注して低血圧状態(安定状態の60%)にし,エピネフリン0.4mgを鼻腔内投与群に4例,舌内投与群5例に投与し血圧・心拍数を記録した.採血は20秒・40秒・1分・5分・10分に行った.結果は鼻腔内投与群では20秒後に2例が,1分後に1例が最高血中濃度に達しそれぞれ1.78ng/mlと0.82ng/ml,0.85ng/mlであった.舌内投与群では5分後に2例が最高血中濃度に達し,40.5ng/ml・16.1ng/mlであったが3例は上昇しなかった.血圧変動は鼻腔内投与群では収縮期圧は20秒後に最も低く5〜10分後には投与前に戻り,拡張期圧は20秒後に最も低く10分後には投与前の77〜119%であった.舌内投与群は収縮期圧は投与後1分まで低下した状態だが10分後には投与前に戻り,拡張期圧は1分後までは投与前より低下あるいはほぼ同じだがそれ以降上昇した.鼻腔内投与群では20秒後に87〜232%まで変動したが10分後には104〜152%であった.舌内投与群では1例のみ急激に上昇し10分後にも147%であったものの他の4例は40秒後までほとんど変化なく,10分後にはほぼ投与前の数値に戻った.今回の研究では血中濃度・上昇する速度は舌内投与群が有利であったが吸収されなかった例もあり確実ではない.緊急時の投与法としてはさらに検討が必要である.

Emergency medicine administration and general intravenous administration, intravenous administration, intravenous treatment, one-time medical treatment, technology and equipment are not necessary, intravenous administration Intranasal administration is necessary and easy, and the nasal mucosa is rich in blood vessels and the drug is absorbed quickly. Test the test. One party, the tongue is the same as the blood vessel, the mouth is rich, the oral cavity is entered, the mouth is operated, the technology and equipment are necessary, and the equipment is necessary. In case of emergency, the emergency supplies are given to the public, and the patient is expected to receive the test. This time, the patient is under general anesthesia and the patient is in a low blood pressure state. Intranasal and tongue administration, measurement of blood concentration, and comparison of intranasal and tongue administration. Intravascular intubation and intravascular intubation.気・ acid element・イソフルランでmaintenanceし,ニトログリセリンを intravenous injectionしてlow blood pressure state (stable stateの60%)にし,エピネフリン0 .4 mg was administered intranasally in 4 cases and intralingually in 5 cases. Blood pressure and heart rate were recorded. Blood collection was performed in 20 seconds, 40 seconds, 1 minute, and 5 minutes.・10 minutes of operation. The results showed that after intranasal administration, 2 cases were found after 20 seconds, and 1 case was found after 1 minute. The highest blood concentration was reached at 1.78ng. /ml, 0.82ng/ml, 0.85ng/ml. The highest blood concentration was reached in 2 cases 5 minutes after intralingual administration of the group, 40 .5ng/ml・16.1ng/ml であったが3 cases はrise しなかった.Blood pressure stimulatingはIntranasal administration group systolic pressure 20 seconds After 5~10 minutes, the back pressure is the lowest and the front pressure is 77~119%.った. Intralingual injection and group systolic pressure 1 minute after the injection, low pressure 10 minutes after the injection, and 1 minute after the contraction pressure, injection The former is lowered and lowered, the same as the lowered and raised. Intranasal administration of the group of 20 seconds is followed by 87~232% of the remaining 10 minutes. After 104~152% of であった. Intralingual injection and group では 1 case of rapid rise of 10 minutes of hou 147% of であったもののhis 4 cases After 40 seconds, the solution will be changed, and after 10 minutes, the solution will be changed to the previous number. This time, the study will focus on blood concentration and rising speed. Injection into the tongue is beneficial to the absorption of the group, and the absorption is good.ではない. How to throw yourself in an emergency and how to do it when it is necessary.