精神分裂病患者腰麻手術時の感覚反応について

STUDIES ON THE SENSORY REACTION OF SCHIZOPHRENICS AT THE OPERATION UNDER LUMBAL ANESTHESIA

緒言

　手術は広い意味の侵襲で，これに対する生体の反応は単純でない。この反応は本来は防禦反応であるが，一面からいえば身辺の平衡状態が失われていることで，増強することは生体にとつて常に有利であるとはいえない。今迄の研究によるとこのような生体の防禦反応は主として自律神経が主役となつている。従来精神疾患特に内因性精神病と防禦反応との関係を考察した者はない。著者等は日常精神患者の診療上感覚鈍麻が推定せられ，特に痛覚に於て之が顕著であることを体験しているので，精神分裂病患者について手術前中後の感覚反応を正常群と比較対照して，かかる事実の有無およびその程度を明瞭ならしめようとした。

I compared 69 schizophrenic patients who had had the operation under lumbal anesthe-sia with those of 150 normal persons.

The results obtained were as follows:

1) Anxiety and fear before the operation in schizophrenics were seen in 3 patients.

Compared with those of normal group, that number of patients was equivalent to a half number of normal persons.

2) There were no differences between the two for pain and agony during the operation.

3) Schizophrenics who complained of the postoperative pain were seen in one fourth of normal group and there were no differences between the two for the initial hour of pain.

In Schizophrenics the antalgic was used only 1 time in 93.3%, 2 times in 6.6%, more than 3 times in 0%.

In normal group the antalgic was used 1 time in 51.3%, 2 times in 29.9%, 3 times in 13.8%, 4 times in 4.3%, even 5 times in 0.7 % and there was a person who needed the antalgic even during the period of 50 hours after the operation.

The rate of pain was proportioned to the abilities of social adaptation apparently in schizophrenics.

4) The differences between the two for the postoperative course were not seen.