ハロセン麻酔下エピネフリン併用小児扁摘術に対する塩酸カルテオロールの不整脈防止効果

Carteolol and Epinephrine-induced Arrhythmia with Halothane Anesthesia during Tonsillectomy

I．はじめに

　扁桃摘出術では出血量減少を目的として術野にepinephrineを使用することが多い。一方，小児扁摘術は全身麻酔下に行われることが多いが，吸入麻酔薬として使用されるhalothaneは，epinephrineに対する心筋の感受性を高め，不整脈を起こしやすい^1）ことが知られている，そこで，halothane麻酔下epinephrine併用小児扁摘術に対し，β遮断薬であるcarteolol hydrochlorideを静脈内に前投与したさいの不整脈防止効果と循環系への影響を非使用例と比較検討したので報告する。

　The effect of prophylactic administration of carteolol, β-adrenergic blocking agent, on the epinephrine-induced arrhythmia during halothane anesthesia was studied in 39 children, ranging from 4 to 13 years in age and undergoing tonsillectomy. The patients were divided into two groups. Group I (n=14) was pretreated with carteolol 2 μg/kg intravenously and group II (n=25) was not. No arrhythmias were observed in group I as opposedto group II in which ventricular arrhythmia occurred in 32 per cent of the patients. Systolic and pulse pressure decreased, but fluctuations in blood pressure and heart rate were mild in group I compared to group II. Our study suggests that the pretreatment of children scheduled for tonsillectomy with carteolol prevents epinephrine-induced arrhythmias, and stabilizes hemodynamics rinrina halnthane anesthesia.