J.Jpn. Surg. Soc.. 55(10): 1104-1119, 1955
Original article
ANOXIA AND HYPOXIA CAUSED BY ANESTHESIA AND OPERATION
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Surgical Department, Tokyo University Branch Hospital Hidetoshi TANAKA |
1) Premedication with narcopone and scoporamine usualy decreased respiratory minute volume by decrease of respiratory rate or amplitude (tidal anoxia). Some of a group given 1.3 cc. or more of narcopone and scopolamine showed cyanosis with increrse of respiratory minute volume. This was considered as alveolar anoxia. Average decrease of 15% of oxygen consumption was found after premedication (histotoxic anoxia). More than half of a group given 1.0 cc. or more of moreof narcopone and scopolamine showed signs of orthostatic hypotension.
2) In the period of induction diminution of minute volume appeared at the 2nd plane, stage III. Obstuction of airway or disfunction of anesthetic machine also induced tidal anoxia. Any anesthetic agent reduced oxygen consumption (histotoxic anoxia), while ether was preved to be causative of some cases of orthostatic hypotinsion (stagnant anoxia).
3) Resection of ribs and opening of pleura diminished respiratory amplitude markedly. Pain would also cut down minute volume (tidal anoxia). Operative maneuver increased oxygen consumption, thus demand anoxia appeared. Anemic anoxia was prevented by sufficient replacement of blood loss during operation.
4) Respiratory state after operation was worst on the first postoperative day, recovering gradually thereafter. Awakening from anesthesia or postoperative pain had some concern with tidal anoxia.
5) Circulatory failure, appearing as orthostatic hypotension, occurred mostly with use of narcotics or anesthetic agents.
6) Opiates and anesthetic agents always precipitated histotoxic anoxia more or less. It must be guarded against such severe histotoxic anoxia attended by respiratory depression, unstable blood pressure and reduction of pulse pressure may happen.
(author's abstract)
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