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The Effects of Anesthesia on Serum Myoglobin and CPK

麻醉对血清肌红蛋白和CPK的影响

基本信息

批准号：
01571110
负责人：
NOGUCHI Izumi
金额：
$ 1.22万
依托单位：
Tsurumi University
依托单位国家：
日本
项目类别：
Grant-in-Aid for General Scientific Research (C)
财政年份：
1989
资助国家：
日本
起止时间：
1989 至 1990
项目状态：
已结题

来源：
https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-01571110/
关键词：
Myoglobin CPK Pediatric anesthesia Halothane Enflurane Thiopental Lidocaine Myoglobinemia チアミラ-ル血清電解質

项目摘要

I have studied the effects of intravenous injection of succinylcholine (SCC) on serum levels of myoglobin (Mb) and CK in 75 children. They were divided into seven groups ; In Group HS, ES, ST2, ST4 and SL, 1mg/kg of SCC was injected intravenously before intubation. In Group H and E, intubation was performed without SCC. In Group ST2 and ST4, thiopental 2mg/kg or 4mg/kg was injected and in Group SL, lidocaine 2 mg/kg was injected prior to the injection of SCC. Anesthesia was induced and maintained with nitrous oxide, oxygen and halothane in Group HS, H, ST2, ST4 and SL, enflurane in Group SE and E, respectively. Blood samples were drawn before and at 5, 20 and 60 min after the injection of SCC. Mb was analyzed by RIA technique and CK was by a modification of Rosalki's method.In Group HS and ES, Mb and CK values values increased remarkably (60 min value, mean <plus-minus> SE : Mb-Group HS ; 2192 <plus-minus>639 ng/ml, Group ES ; 1722<plus-minus>436 ng/ml, CK-Group HS ; 174.1<plus-minus>32.9 IU/l, Group ES ; 193.6 <plus-minus>35.7 IU/l). Though Mb values increased in Group H (40 <plus-minus>12ng/ml) and Group E (43 <plus-minus>9 ng/ml), they were significantly less than Group HS and ES, and CK values in increased neither groups. In the two thiopental injected groups, the increase in values was significantly less in Group ST4 (Mb : 685<plus-minus>140 ng/ml, CK : 114.0<plus-minus>15.7 ng/ml) than Group ST2 (Mb : 1932<plus-minus>478 ng/ml, CK : 251.2<plus-minus>57.7 ng/ml) and no significant difference was found between Group ST2 and Group HS. In Group SL, Mb and CK values increased (Mb : 1536<plus-minus>679 ng/ml, CK : 174<plus-minus>39.2ng/ml) and significant difference was notThese results indicate that the increase of values is mainly induced by SCC, and though thiopental 4mg/kg is effective to suppress the increase, 2mg/kg is not. Lidocaine is not considered to increase the values and is thought to be used on patient of myoglobinuria.

本文观察了75例小儿静脉注射琥珀胆碱（SCC）对血清肌红蛋白（Mb）和肌酸激酶（CK）的影响。HS组、ES组、ST 2组、ST 4组、SL组于插管前静脉注射SCC 1 mg/kg。H组和E组在无SCC的情况下进行插管。ST 2、ST 4组在注射SCC前注射硫喷妥钠2 mg/kg或4 mg/kg，SL组在注射SCC前注射利多卡因2 mg/kg。HS、H、ST 2、ST 4和SL组分别用笑气、氧气和氟烷诱导和维持麻醉，SE和E组分别用安氟醚诱导和维持麻醉。分别于注射SCC前、注射SCC后5、20、60 min采血。HS组和ES组的Mb和CK值均显著升高（60 min值，平均<plus-minus>SE：Mb-HS组：2192 <plus-minus>639 ng/ml，ES组：1722 436 ng<plus-minus>/ml，CK-HS组：174.1 <plus-minus>32.9 IU/l，ES组：193.6 <plus-minus>35.7 IU/l）。H组（40 <plus-minus>12 ng/ml）和E组（43 <plus-minus>9 ng/ml）Mb值虽有升高，但明显低于HS组和ES组，CK值均无升高。在两个硫喷妥钠注射组中，ST 4组（Mb：685 <plus-minus>± 140 ng/ml，CK：114.0 <plus-minus>± 15.7 ng/ml）的值的增加显著小于ST 2组（Mb：1932 <plus-minus>± 478 ng/ml，CK：251.2 ± <plus-minus>57.7 ng/ml），ST 2组与HS组之间无显著差异。SL组Mb和CK值升高（Mb：<plus-minus>1536679 ng/ml，CK：17439.2ng<plus-minus>/ml），但无显著性差异。结果表明，Mb和CK值的升高主要是SCC引起的，硫喷妥钠4 mg/kg能有效地抑制Mb和CK值的升高，而2 mg/kg则不能。认为利多卡因不会增加该值，并认为其用于肌红蛋白尿患者。