The effects of isoflurane anesthesia on serum myoglobin, CPK and electrolytes

本文研究了异氟烷对Sch所致大鼠血清肌红蛋白(Mb)和肌酸激酶(CK)升高的影响。78例患儿随机分为4组，两组(IV组，IM组)用N20、02和异氟醚诱导维持，后两组(HV组，HM组)用氟烷替代异氟醚。在意识丧失后，IV组和IH组静脉注射SCH 1 mg/kg，IM组和IH组肌肉注射SCH 2 mg/kg以便于气管插管。抽取血样至60min。MB测定采用放射免疫法，CK测定采用改良Rosalki法。结果：各组Mb值从5min开始升高，CK值在IV组和HV组从5min开始升高，IM组和HM组在60min时升高。IV组60min时Mb为对照的120倍，CK为对照的5倍。IM组和HM组的值小于IV组和HV组，并注意到增长的延迟。IV组与HV组、IM组与HM组之间无显著差异。IM组和HM组至20min时K^+值显著升高，而IV组和HV组在60min时K^+值显著下降。IV组和HM组无机磷在5min时升高，HV组、IM组和IM组在60min时下降。Na~(++)和Ca~(2+)~(2+)从5min开始下降，并持续到60min。Mb和K值的升高无相关性。提示异氟醚麻醉期间应慎重避免肌红蛋白血症或恶性体温升高。

The effect of isoflurane on the increase in serum myoglobin (Mb) and creatinekinase (CK) levels induced by Sch was studied. 78 children were divided into four groups ; in the two groups (Group IV, IM), the induction and maintenance was achieved with N20, 02 and isoflurane, and in the last two groups (Group HV, HM) halothane was administered instead of isoflurane. After loss of consciousness, they were injected with Sch 1mg/kg intravenously in Group IV and IH, and 2mg/kg intramusculaly in Group IM and IH to facilitate tracheal intubation. Blood samples were drawn till 60 min. Mb was determined by the radioimmunoassay and CK was by the modified Rosalki's method. AS a result, Mb values increased from 5 min in all groups, and CK values increased from 5 min in Group IV and HV, and at 60 min in Group IM and HM. The value in Group IV at 60 min was 120 times higher than the control data in Mb, and 5 times in CK, respectively. The values in Group IM and HM were less than Group IV and HV, and the delays in increases were noted. There was not a significant difference in the values between Group IV and HV, or Group IM and HM. K^+ value increased remarkably in Group IM and HM till 20 min, and decreased in Group IV and HV at 60 min. Inorganic phosphate increased at 5min in Group IV and HM, and decreased in Group HV, IM and IM at 60min. Na^+ and Ca^<2+> decreased from 5 min, and the decreases lasted till 60 min. No correlationship was occurred in increases in Mb and K values. It is indicated that we should be cautious to avoid myoglobinemia or possibly malignant hyperthermia, during isoflurane anesthesia.