脳手術時の末梢循環動態

PERIPHERAL CIRCURATION DURING A CEREBRAL OPERATION

　如何なる手術に於いても，その手術管理は極めて重要なる問題である。特に生体の諸中枢の存在する脳手術に際しては特に重要視されねばならない。而も之らの手術管理の中でも循環系の態度は直接患者の生命を左右する問題であるが，我々は名大橋本外科に入院し主として開頭術を施行した患者を対象として，指尖部光電容積脈波^1）2）及び心電図（第II誘導を以つて代表せしめた）の同時記録により観察を試みた。

Peripheral circulation during a cerebral ope-ration was observed by means of EKG and photoelectric plethymography.

By operative stress to a cerebrum, tachy-cardia, decreasing of pulse waves and evide-nt respiratory fluctuation waves appeared.These findings were recognized on any part of a cerebrum or any kind of operation. Tne-rewithal, by the operative stress to hypotha-lamus, two kinds of chainging, that is, tachy-cardia and decreasing of pulse waves or bra-dycardia and increasing of pulse waves, were observed. The chainging due to hypothala-mus were very evident as compared with the chaingings described upper. The chaingings described upper were influenced by a method of anesthesia.

Under pharmacological hibernation, these findings were observed plainly. Under gene-ral hypothermia, we could not observe any chainging due to the stress to a cerebrum at low body temperature, but at rewarming the chainging due to the cerebral stress appered strongly. Under intratracheal anesthesia,only the slight decreasing of pulse waves and tachycardia were observed. And it is consi-dered that the operation under intratracheal anesthesia has better circulation than the other anesthesia.