Læknablaðið - 01.08.1977, Blaðsíða 41

LÆKNABLAÐIÐ
149
stæðulaust. Hafa verður í huga að enfluran
eykur á verkun „ekki depolariserandi“
lyfja (curare, gallamín, pancuronium).8
Fyrsta rannsóknin um notkun enflurans
í sambandi við fæðingaraðgerðir birtist í
sept. 1975.7 Með dýratilraunum hefur ekki
tekist að sýna fram á fósturskaða af völd-
um lyfsins.
Niðurstaða
Verkun enflurans og halotans er mjög
svipuð. Lyfin hafa sambærileg áhrif á
blóðþrýsting og öndun, en svæfingastig
sjúklinga, sem svæfðir eru með enfluran
breytist hraðar með breyttri þéttni. Tíðni
hjartsláttaróreglu enflurans og adrenalíns
er lægri en halotans og adrenalíns. Lyfið
er ekki talið hafa skaðleg áhrif á lifur eða
nýru. Vöðvaslappandi áhrif enflurans eru
meiri en halotans. Sjúklingar vakna fyrr
eftir enfluran en halotan svæfingu. Lítil
reynsla er ennþá fengin af notkun enflur-
ans við fæðingaraðgerðir. Lyfið veldur
verulegum breytingum á heilariti og fá-
einir sjúklingar hafa fengið krampa. Hvort
þessi áhrif á miðtaugakerfi eru skaðleg er
ekki enn vitað með vissu, þótt flestir telji
að svo sé ekki.
SUMMARY
Fifty patients, ranged in age from 2 L>
months to 87 years were included in clinical
study of anesthesia with enflurane t+N^O/
O2). Various surgical procedures were included
in the study and required between 30 minutes
and 5 hours for completion.
Satisfactory anesthesia was obtained in all
cases. Induction was smooth and marked by
absence of coughing or breathholding when the
anesthetic agent was introduced. Induction and
recovery are shorter with enflurane than with
halothane but there is little difference between
the drugs in respect of their post-operative
sequelae. One patient showed ventricular extra-
systoles in bigeminal rhythm during intubation,
otherwise cardiac rhythm and pulse were
stable. Blood pressure decreased rather
markedly in four patients after induction,
which responded to the rapid infusion of
fluids and the decrease in the concentration of
inspired anesthesia. Enflurane causes a dose-
related respiratory depression with a signifi-
cant decrease in minute volume and tidal
volume. Muscular relaxation and analgesia are
better than those observed with halothane.
In this study no instances of seizure-like
activity during anesthesia were detected, de-
spite careful observation. The EEG patterns
during anesthesia with enflurane are discussed.
HEIMILDIR
1. Alexander, S.C. ASA Regional refresher
courses in anesthesiology vol. 1, bls. 1—13
1973. Anesthesia and the cerebral circu-
lation.
2. Ball, C.G., DiFazio C.A., and Eastwood,
D. W. Limited concentration enflurane anes-
thesia. Soutliern Medical Journal, 65:1347-
51, 1972.
3. Bart, A.J., Homi, J., Linde, H.W. Changes
in power spectra of electro-encephalograms
during anesthesia with fluroxene, methoxy-
flurane and Ethrane. Anesth. Analg. 50:53-
63, 1971.
4. Botty, C., Brown, B., Stanley, V. et al.
Clinical experiences with compound 347, a
halogenated anest'hetic agent. AnesthAnalg.
(Cleveland) 47:499-505, 1968.
5. Calverley, R.K., Smith, N.T., Jones, C.W.,
E. I. Eger II., Roberts P.C. and Schaldach
A.L. Abstracts of scientific papers. 1975
ASA Annual meeting bls. 259—260.
6. Chase, R.E., Holaday, D.A., Bergerova, F.V.,
Saidman L.J., Mack F.E. The biotransfor-
mation of Ethrane in man. Anesthesiology
35: No. 3, September 1971.
7. Coleman, A.J., Downing J.W. Enflurane
anesthesia for Cesarean section. Anestliesio-
logy 43:354-57, 1975.
8. Dobkin, A.B., Nishioka, K., Gengaje, D.B.,
et al. Ethrane (compound 347) anesthesia:
A clinical and laboratory review of 700
cases. Anestli. Analg. (Cleveland) 48:477-
494, 1969.
9. Findeiss, J.C., Kien, G.A., Huse, J.O.W. et
al. Power spectral density of the electro-
encephalogram during halothane and cyclo-
propane anesthesia in man. Anesth. Analg.
48:1018, 1969.
10. Johnston, R.E. & Eger, E.I. II: A compara-
tive interaction of epinephrine with halo-
thane, enflurane and isoflurane in man.
Abstracts of scientific papers 1974 ASA,
Annual meeting bls. 55.
11. Katz, R.L., Matteo, R.S. & Papper E.M.
The injection of epinephrine during general
anesthesia with halogenated hydrocarbons
and cyclopropane in man. 2. Halothane.
Anesthesiology 23:597, 1962.
12. Linde, H.W., Lamb, V.E., Quinsby Jr., C.W.,
Homi, J., Eckenhoff, J.E. The search for
better anesthetic agents: Clinical investi-
gation of Ethrane. Anesthesiology 32-555-
59, 1970.
13. Mazze, R.I., Calverley, R.K., Smith, N.T.,
Jones, C.W. Abstracts of scientific papers,
ASA Annual meeting 1975, bls. 225-26.
14. Munson, E.S., Tucker, W.K. Doses of epi-
nephrine causing arrythmia during en-
flurane, methoxyflurane and halothane
anesthesia in dogs. Canad. Anaesth. Soc. J.
22:495-501, 1975.
15. Neigh, J.L., Garman, J.K., Harp, J.R. The