人工虎骨粉对老年骨质疏松性腰背疼痛的作用

目的了解人工虎骨粉治疗老年原发性骨质疏松症所引发腰背疼痛的治疗效果,并探讨其可能的机制。方法选择原发性骨质疏松症腰背疼痛老年患者76例,采用随机信封法分为治疗组和对照组,每组各38例。治疗组另外给予人工虎骨粉口服,对照组给予碳酸钙和维生素D口服。治疗前、治疗后第3、6个月,分别运用数字疼痛评分(numeric rating scale,NRS)、视觉模拟疼痛评分(visual analogue scale,VAS)对疼痛进行评估;运用Oswestry功能障碍指数(oswestry dability index,ODI)、JOA下腰功能(Japanese Orthopaedic Association,JOA)评分对腰背功能进行评估。结果治疗前两组患者疼痛及腰背功能无差别。治疗后第3、6个月,治疗组的NRS评分、VAS评分、ODI指数、JOA评分均优于对照组(P0.05)。结论人工虎骨粉能够缓解老年原发性骨质疏松症所引发的腰背疼痛,可改善患者腰背功能,提高日常活动能力。     

全身振动训练结合雷火灸治疗原发性骨质疏松症腰背痛的临床观察

目的探讨雷火灸干预原发性骨质疏松症腰背痛患者的临床疗效。方法纳入符合诊断标准的原发性骨质疏松症腰背痛患者60例,采用信封法随机分为全身振动训练结合雷火灸组(A组)和全身振动训练组(B组),每组30例。运用视觉模拟评分法(VAS)、Oswestry功能障碍指数问卷表(ODI)、Berg平衡量表(BBS)分别在治疗前、治疗4周结束时及治疗结束后1个月随访时进行评估。结果组间比较,治疗结束时及1个月随访时,VAS及ODI评分有差异(P0.05);BBS评分无差异(P0.05);组内比较:治疗结束时及1个月随访时与治疗前比较,VAS、ODI、BBS等评分均有差异(P0.05);1个月随访与治疗结束时比较VAS、ODI、BBS等评分均无差异(P0.05)。结论全身振动训练结合雷火灸在改善原发性骨质疏松症腰背痛患者VAS和ODI评分方面优于全身振动训练组,但在平衡能力改善方面两组无显著差异。     

补肾健脾针刺法治疗老年男性原发性骨质疏松症的临床疗效评估研究

目的初步评估单纯补肾健脾针刺法对老年男性原发性骨质疏松症的临床疗效。方法将60例首次确诊为原发性骨质疏松症的老年男性随机分为针刺组和假针刺组。针刺组选择双侧肾俞、脾俞、命门、足三里、关元穴和疼痛部位的阿是穴。假针刺组针刺点为针刺组穴位旁开2寸处。手法进针,留针30 min,每周2次,3个月为一个疗程。评估指标为治疗前后两组患者的VAS疼痛评分、中医证候改善情况及两组患者腰椎及左侧股骨颈的骨密度(bone mineral density,BMD)值。结果经过3个月的治疗,针刺组的VAS疼痛评分较治疗前显著降低(t=16.307,P0.01),而假针刺组并没有发生大的变化(P0.05);治疗后,两组间的VAS疼痛评分差异有统计学意义(P0.01)。治疗后,针刺组的中医证候改善的总有效率明显高于假针刺组(χ~2=33.61,P0.05)。治疗后,针刺组的腰椎及左侧股骨颈BMD值较治疗前有提高趋势,但这种差异并没有统计学意义(P0.05);而假针刺组腰椎及左侧股骨颈的BMD值较治疗前并没有发生大的变化(P0.05)。结论短疗程的单纯补肾健脾针刺法可以改善老年男性原发性骨质疏松症患者的疼痛症状和中医证候,并且这种临床症状的改善要早于骨密度的改善。     

改良五禽戏防治原发Ⅰ型骨质疏松症的临床应用体会

目的探讨改良五禽戏防治原发Ⅰ型骨质疏松症的临床疗效。方法将60例原发Ⅰ型骨质疏松症患者随机分成2组,试验组30例予华佗五禽戏锻炼,对照组30例保持日常生活不变,于试验前、试验后6个月对2组腰椎骨密度值、骨代谢指标(I型原胶原N端前肽和I型胶原羧基末端肽)、腰背部疼痛评分(VAS评分)的变化情况进行统计分析。结果试验6个月后,试验组腰椎骨密度较对照组无统计学意义(P0.05),但骨代谢指标、腰背部疼痛评分(VAS评分)较对照组显著降低(P0.05)。结论改良五禽戏锻炼在短期内提高腰椎BMD的作用不甚明显,但可显著降低原发Ⅰ型骨质疏松患者血清中PINP、S-CTX水平、腰背部疼痛评分,改善患者生活质量,是防治骨质疏松症的一种有效方法。     

脉冲电磁场辅助治疗原发性骨质疏松症疗效分析

目的观察脉冲电磁场对原发性骨质疏松症患者骨痛,日常生活活动及骨密度的影响。方法收集原发性骨质疏松症患者120例,其中男性50例,女性70例。年龄50~88岁,平均68±15岁。随机分为2组,治疗组60例,对照组60例,治疗组采用HX2010型脉冲电磁场骨质疏松治疗系统联合钙剂,维生素D及双膦酸盐治疗,对照组采用钙剂,维生素D及双膦酸盐治疗,连续治疗24周。治疗前后分别测定患者VAS疼痛评分,ADL日常生活活动评分及骨密度,并进行统计学分析。结果治疗前两组VAS疼痛评分无统计学差异,治疗后4周治疗组VAS评分下降,与对照组相比有显著性差异;治疗前两组ADL评分无差异,治疗后4周ADL评分升高,与对照组相比有显著性差异;治疗前两组骨密度无差异,治疗后24周骨密度明显升高,与对照组相比有显著性差异。结论脉冲电磁场可缓解原发性骨质疏松症的骨痛,效果较为显著,能够明显改善患者的日常生活活动能力,可提高骨密度。     

针刺结合悬吊技术治疗"骨盆前倾-腰曲增加"型慢性非特异性下腰痛的临床疗效

目的 观察针刺结合悬吊技术对"骨盆前倾-腰曲增加"型慢性非特异性下腰痛(chronic non-specific low back pain,CNLBP)的临床疗效.方法 将骨盆前倾-腰曲增加型CNLBP患者194例随机分为治疗组94例和对照组100例.治疗组给予针刺结合悬吊技术治疗,对照组给予洛索洛芬钠片60 mg口服治疗.对两组患者VAS评分、腰腿痛功能评分、腰部活动范围、腰背肌力进行评定.结果 治疗4周后,两组VAS评分、腰腿痛功能评分、腰部活动范围和腰背肌力均明显优于治疗前(P<0.01).第1～4周,治疗组VAS评分、腰部活动范围和腰背肌力均显著优于对照组(P<0.05);第2～4周,治疗组腰腿痛功能评分均显著优于对照组(P<0.05).结论 两种方案均是治疗CNLBP的有效方案,但针刺结合悬吊技术在改善疼痛、腰部功能、腰部活动范围、腰背肌力方面的效果更显著.     

心律失常射频消融术后焦虑状态患者的静息态MRI低频振幅分析

目的采用低频振幅(ALFF)观察心律失常射频消融术后出现焦虑状态患者的全脑功能活动。方法收集符合纳入标准的26例心律失常射频消融术(RFCA)后焦虑状态患者作为RFCA组,纳入同期年龄、性别相匹配的26名健康志愿者作为正常对照组,2组均行fMRI,对2组有差异脑区的ALFF进行双样本t检验,提取有差异的脑区与汉密尔顿焦虑量表评分进行偏相关分析。结果与正常对照组相比,RFCA组左侧颞中回、右侧壳核、左侧杏仁核ALFF增高,左侧前额叶背外侧皮层(DLPFC)、右侧楔前叶、左侧额中叶、右侧枕中叶ALFF减低差异有统计学意义(Alphasim校正,P0.01)。左侧DLPFC的ALFF值与HAMA评分呈负相关(r=-0.872,P=0.013)。结论心律失常射频消融术后焦虑状态患者在静息状态下存在脑功能的异常,ALFF有助于为该疾病的发病机制提供更多证据。     

脉冲电磁场辅助治疗对原发性骨质疏松症的疗效观察

目的 观察脉冲电磁场结合钙剂和维生素D治疗对原发性骨质疏松症患者骨痛、日常活动能力和骨密度等的影响.方法 收集原发性骨质疏松症患者120例,其中,男性50例,女性70例.年龄50～90岁,平均(68±15)岁.随机分为两组,其中治疗组66例,对照组54例.治疗组采用BG100-A型骨质疏松治疗系统联合维生素D和钙剂口服,对照组采用单纯钙剂和维生素D口服,连续治疗至少60 d.治疗前后分别测定患者VAS疼痛评分、ADL日常生活活动评分和骨密度.结果 ①治疗组VAS评分在治疗后1月即开始下降,治疗后2月VAS评分进一步下降,与对照组相比均有显著性差异(P<0.01);② 治疗后1月治疗组ADL评分升高,治疗后2月ADL评分进一步上升,与对照组相比均有显著性差异(P<0.01);③ 治疗后1月治疗组骨密度即升高7.9%,治疗后2月治疗组骨密度进一步升高,与对照组相比差异显著(P< 0.05).结论 脉冲电磁场可显著提高骨密度,缓解原发性骨质疏松症的临床骨痛,并能够明显改善患者的日常生活活动能力.     

小针刀疗法干预治疗老年性骨质疏松症的疗效观察

目的 观察小针刀疗法缓解老年性骨质疏松症患者腰背痛的疗效。方法 将46例患者随机分为治疗组和对照组各23例,治疗组选择西药治疗加小针刀疗法方案,对照组采用单纯西药治疗方案,治疗组疗程为4周,对照组疗程为6周,采用视觉模拟评分法(VAS)评价治疗前后得分对腰背痛进行量化动态观察,依据“Barthel指数评定法”对老年性骨质疏松症日常生活活动能力(ADL)进行观察,评价小针刀疗法干预治疗老年性骨质疏松症的临床效果。结果 视觉模拟评分法(VAS )评价显示对于疼痛治疗组治疗后2周、一疗程与治疗前均明显差异(P<0.05),同时与对照组有明显差异(P < 0. 05)优于对照组。日常生活活动能力(ADL)评价显示治疗组治疗后2周、一疗程与治疗前有明显差异(P<0.05),同时与对照组有明显差异(P<0.05)优于对照组。结论 小针刀松疗法对老年性骨质疏松症腰背痛有明确的缓解疼痛、改善证候的作用,且见效快、创伤小、不良反应少、操作简单。     

意大利筋膜手法治疗慢性非特异性腰痛患者的疗效研究

目的 探讨意大利筋膜手法对慢性非特异性腰痛患者的疗效.方法 2019年11月～2020年11月,选取40例慢性非特异性腰痛患者,随机分为筋膜组(n=20)和推拿组(n=20).两组均进行家庭训练2周,1次/d;筋膜组在此基础上辅以筋膜手法,治疗2周,每周2次;推拿组辅以推拿治疗,治疗2周、每周2次.在治疗前、治疗后和随访1个月后,分别采用VAS评分、ODI指数、腰背核心肌群屈伸和旋转的峰力矩(peak torque,PT)进行疗效评价.结果 治疗后两组腰背核心肌群屈伸和旋转的PT和VAS评分、ODI指数均较治疗前显著改善(P<0.05);但与推拿组相比,筋膜组的PT改善更显著(P<0.05).随访1个月,推拿组各项评分显著差于治疗后(P<0.05);而筋膜组VAS评分和ODI指数较治疗后改善更显著(P<0.05).结论 筋膜手法可有效减轻慢性非特异性腰痛患者的疼痛,更有效地改善功能障碍,其长期疗效和预防作用较好.     

Vasopressor hormone response following mesenteric traction during major abdominal surgery

Background : We investigated the vasopressor hormone response following mesenteric traction (MT) with hypotension due to prostacyclin (PGI₂) release in patients undergoing abdominal surgery with a combined general and epidural anesthesia. Methods : In a prospective, randomized, placebo-controlled study we administered 400 mg ibuprofen (i.v.) in 42 patients scheduled for abdominal surgery. General anesthesia was combined with epidural anesthesia (T4-L1). Before as well as 5, 15, 30, 45, and 90 min after MT we recorded plasma osmolality, hemodynamics and measured 6-keto-PGFlα (stabile metabolite of PGI₂), TXB₂ (stabile metabolite of thromboxane A₂) active renin, and arginine vasopressin (AVP) plasma concentrations by radioimmunoassay. Catecholamine levels were assessed by high-pressure liquid chromatography (HPLC) with electrochemical detection. Results : Following MT, arterial hypotension occurred along with a substantial PGI₂ release. This was completely abolished by ibuprofen administration. Although plasma levels of 6-keto-PGF_1α (1133 (708) vs. 60 (3) ng/L, median (median absolute deviation), P=0.0001, placebo vs. ibuprofen) remained significantly elevated, blood pressure was restored within 30 min after MT in the placebo group. At the same point in time plasma concentrations of TXB² (164 (87) vs. 58 (1) ng/L, P=0.0001), epinephrine (46 (33) vs. 14 (6) ng/L, P=0.001), AVP (41 ± (18) vs. 12 (7) ng/L, P=0.0004), and active renin (27 (12) vs. 12 (4) ng/L, P = 0.001) were significantly higher in placebo-treated patients. Conclusion : Under combined general and epidural anesthesia arterial hypotension following MT due to endogenous PGI₂ release is associated with enhanced release of AVP, active renin, epinephrine and thromboxane A₂, presumably contributing to hemodynamic stability within 30 min after MT.     

A Teaspoon Pump for Pumping Blood with High Hydraulic Efficiency and Low Hemolysis Potential

Abstract: Virtually all blood pumps contain some kind of rubbing, sliding, closely moving machinery surfaces that are exposed to the blood being pumped. These valves, internal bearings, magnetic bearing position sensors, and shaft seals cause most of the problems with blood pumps. The original teaspoon pump design prevented the rubbing, sliding machinery surfaces from contacting the blood. However, the hydraulic efficiency was low because the blood was able to "slip around" the rotating impeller so that the blood itself never rotated fast enough to develop adequate pressure. An improved teaspoon blood pump has been designed and tested and has shown acceptable hydraulic performance and low hemolysis potential. The new pump uses a nonrotating "swinging" hose as the pump impeller. The fluid enters the pump through the center of the swinging hose; therefore, there can be no fluid slip between the revolving blood and the revolving impeller. The new pump uses an impeller that is comparable to a flexible garden hose. If the free end of the hose were swung around in a circle like half of a jump rope, the fluid inside the hose would rotate and develop pressure even though the hose impeller itself did not "rotate"; therefore, no rotating shaft seal or internal bearings are required.     

Microspheres Based Detoxification System: A New Method in Convective Blood Purification

Abstract: A variety of protein-bound or hydrophobic substances, accumulating as a result of pathologic conditions such as exogenous or endogenous intoxications, are removed poorly by conventional detoxification methods because of low accessibility (hemodialysis), insufficient adsorption capabilities (hemosorption), low efficiency (peritoneal dialysis), or economic limitations (high-volume plasmapheresis). Combining advantages of existing methods with microspheric technology, a module-based system was designed. Major operating parameters of the latter can be modified to allow for adjustment to individual clinical situations. An extracorporeal blood circuit including a plasmafilter is combined with a secondary high-velocity plasma circuit driven by a centrifugal pump. Different microspheric adsorbers can be combined in one circuit or applied in sequence. Thus, a prolonged treatment can be tailored using specially designed selective adsorber materials. Comparing this system with existing methods (high-flux hemodialysis, molecular adsorbent recycling system), results from our in vitro studies and animal experiments demonstrate the superior efficiency of substance removal.     

Tissue perfusion in relation to cardiac output during continuous positive-pressure ventilation and administration of propranolol or verapamil

Background : Our objective was to determine whether administration of propranolol or verapamil modifies the hemodynamic adaptation to continuous positive-pressure ventilation (CPPV), in particular the regional distribution of cardiac output (CO).
Methods : General hemodynamics and regional blood flows assessed by microsphere technique (15 (μm) were recorded in 16 anesthetized pigs during spontaneous breathing (SB) and CPPV with 8 cm H₂O end-expiratory pressure (CPPV8) before and after intravenous administration of propranolol (0.3 mg · kg⁻¹ followed by 0.15 mg · kg⁻¹ · h⁻¹, n=8) or verapamil (0.1 mg · kg⁻¹ followed by 0.3 mg · kg⁻¹ · h⁻¹, n=8).
Results : CPPV8 depressed CO by 25% without shifts in its relative distribution with the exception of a noteworthy increase in adrenal perfusion. Propranolol increased arterial blood pressure, and due to a fall in heart rate, CO dropped by 25%. The kidneys and, to a lesser extent, the splanchic region and central nervous system received increased fractions of the remaining CO at the expense of skeletal muscle flow. Similar patterns were seen during SB and CPPV8 such that the combination of propranolol and CPPV8 depressed CO by 50%. The circulatory effects of verapamil were less evident but myocardial perfusion tended to increase.
Conclusions : The combination of propranolol or verapamil with CPPV does not result in any specific hemodynamic interaction in anesthetized pigs, except that the combined effect of propranolol and CPPV may severely reduce CO.     

Bariatric Surgery in Some "Central and East-European (former Eastern bloc)"Countries - Current Status and Prediction for the Next Millennium

Background: Obesity is increasing globallly, including in the formerly "Eastern Bloc" countries. Methods: A survey was made of obesity and bariatric surgery. Results: In the 8 East and Central European countries studied, with total population 300 million, roughly 43% of the population was overweight (BMI 25-30), 23% obese (BMI > 30), with about 15 million people morbidly obese (BMI > 40). From 0-10 morbidly obese individuals/100,000/year undergo bariatric surgery. Conclusion: Most countries were found to provide inadequate treatment for obesity.The majority of the morbidly obese are not treated effectively. However, health-care awareness of obesity and bariatric surgeons are slowly increasing.     

Volatile anaesthetics reduce adhesion of blood platelets under low-flow conditions in the coronary system of isolated guinea pig hearts

Background : Inhibitory effects of volatile anaesthetics on platelet aggregation have been demonstrated in several studies. However, the influence of volatile anaesthetics on intracoronary platelet adhesion has not been elucidated so far.
Methods : Isolated hearts of guinea pigs were perfused with buffer in the absence or presence of volatile anaesthetics (0.5 and 1 MAC) at constant coronary flow rates of 5 ml/min for 25 min, then 1 ml/min for 30 min and again 5 ml/min for 10 min. Before, during and after low-flow perfusion, a bolus of human platelets was applied into the coronary system. To simulate thrombogenic conditions, 0.3 U/ml human thrombin was infused during low-flow perfusion and reperfusion. The number of platelets sequestered to the endothelium was calculated from the difference between coronary in- and output of platelets. The myocardial production of lactate and consumption of pyruvate and coronary perfusion pressure were also determined.
Results : At a flow rate of 5 ml/min only about 3% of the applied platelets did not emerge from the coronary system, in any group. In contrast, 13.1±1.2% (mean±SEM) of infused platelets became adherent in low-flow perfusion in the control group without anaesthetic. The adherence was reduced with each 1 MAC isoflurane (to 6.2±1.2%), sevoflurane (to 4.4±0.9%) or halothane (to 3.2±1.5%) (each P <0.05 vs. control). Volatile anaesthetic, 0.5 MAC, did not inhibit platelet adhesion to a statistically significant extent in any case. Perfusion pressure and metabolic parameters were not statistically different between the control and the hearts exposed to anaesthetics.
Conclusion : Volatile anaesthetics in a concentration of 1 MAC can reduce the adhesion of platelets in the coronary system under reduced flow conditions. This action does not arise from vasodilation or inhibition of ischaemic stress.     

Synergistic interaction between the effects of propofol and midazolam with fentanyl on phrenic nerve activity in rabbits

Background: It has been shown that the depressive effects of both propofol and midazolam on consciousness are synergistic with opioids, but the nature of their interactions on other physiological systems, e. g. respiration, has not been fully investigated. The present study examined the effect of propofol and midazolam alone and in combination with fentanyl on phrenic nerve activity (PNA) and whether such interactions are additive or synergistic. Methods: PNA was recorded in 27 anaesthetised and artificially ventilated rabbits. In three groups, propofol, fentanyl and midazolam were administered intravenously in incremental doses to construct dose-response curves for the depressant effects of each one on PNA. In another two groups, the effect of pretreatment with either fentanyl 1 μg · kg^?1 i. v. or midazolam 0.05 mg · kg^?1 i. v. on the effects of propofol and fentanyl respectively on PNA were studied. Results: Propofol and fentanyl caused a dose-dependent depression of PNA with complete abolition at the highest total doses of 16 mg · kg^?1 i. v. and 32 μg · kg^?1 i. v., respectively. In contrast, midazolam in incremental doses to a total of 0.8 mg · kg^?1 reduced mean PNA by 63%, but approximately 12% of PNA remained at a total dose as high as 6.4 mg · kg^?1. The mean ED₅₀s, calculated from dose-response curves, were 5.4 mg · kg^?1, 3.9 μg · kg^?1 and 0.4 mg · kg^?1 for propofol, fentanyl and midazolam, respectively. Initial doses of either fentanyl 1 μg · kg^?1 i. v. or midazolam 0.05 mg · kg^?1 i. v. acted synergistically with subsequent doses of either propofol or fentanyl to abolish PNA at total doses of 8 mg · kg^?1 and 8 μg · kg^?1, respectively. Conclusion: Fentanyl has a synergistic interaction with both propofol and midazolam on PNA and hence potentially on respiration.     

Influence of dopexamine hydrochloride on haemodynamics and regulators of circulation in patients undergoing major abdominal surgery

Background: Catecholaminergic support is often used to improve haemodynamics in patients undergoing major abdominal surgery. Dopexamine is a synthetic vasoactive catecholamine with beneficial microcirculatory properties. Methods: The influence of perioperative administration of dopexamine on cardiorespiratory data and important regulators of macro- and microcirculation were studied in 30 patients undergoing Whipple pancreaticduodenectomy. The patients received randomized and blinded either 2 μg · kg^?1 · min^?1 of dopexamine (n=15) or placebo (n=15, control group). The infusion was started after induction of anaesthesia and continued until the morning of the first postoperative day. Endothelin-1 (ET-1), vasopressin, atrial natriuretic peptide (ANP), and catecholamine plasma levels were measured from arterial blood samples. Measurements were carried out after induction of anaesthesia, 2 h after onset of surgery, at the end of surgery, 2 h after surgery, and on the morning of the first postoperative day. Results: Cardiac index (CI) increased significantly in the dopexamine group (from 2.61±0.41 to 4.57±0.78 1 · min^?1 · m^?2) and remained elevated until the morning of the first postoperative day. Oxygen delivery index (DO₂I) and oxygen consumption index (VO₂I) were also significantly increased in the dopexamine group (DO₂I: from 416±91 to 717±110 ml/m² · m²; VO₂I: from 98±25 to 157±22 ml/m² · m²), being significantly higher than in the control group. pHi remained stable only in the dopexamine patients, indicating adequate splanchnic perfusion. Vasopressive regulators of circulation increased significantly only in the untreated control patients (vasopressin: from 4.37±1.1 to 35.9±12.1 pg/ml; ET-1: from 2.88±0.91 to 6.91±1.20 pg/ml). Conclusion: Patients undergoing major abdominal surgery may profit from prophylactic perioperative administration of dopexamine hydrochloride in the form of improved haemodynamics and oxygenation as well as beneficial influence on important regulators of organ blood flow.     

Systemic analgesia adapted to the children's condition

A concept of balanced analgesia using nonsteroidal anti-inflammatory drugs (NSAIDs), paracetamol (acetaminophen), opioids, and corticosteroids can also be used in patients with pre-existing illnesses. NSAIDs are the most effective treatment for acute pain of moderate intensity in children; however, these drugs should be avoided in patients at increased risk for serious side effects, e.g. patients with renal impairment, bleeding tendency, or extreme prematurity. NSAIDs can be given with minimal risks to the younger child with mild to moderate asthma, and, in these patients, the use of steroids can be encouraged; in addition to their antiemetic and analgesic action, a beneficial effect on asthma symptoms can be expected. In the non-intubated child with cerebral trauma, exaggerated sedation caused by opioids and increased bleeding tendency caused by NSAIDs must be avoided. In neonates and small infants, the oral administration of sucrose or glucose is helpful to minimize pain reaction during short uncomfortable interventions.     

A comparison of the inhibitory effects of four volatile anaesthetics on the metabolism of chlorzoxazone, a substrate for CYP2E1, in rabbits

Background: Halothane inhibits in vitro and in vivo activity of cytochrome P-450 (CYP) 2E1. There are several fluorinated volatile anaesthetics besides halothane, and most of them are defluorinated by CYP2E1. It is unclear whether other fluorinated anaesthetics inhibit the in vivo activity of CYP2E1.
Methods: We compared the inhibitory effects of therapeutic concentrations of four inhalational anaesthetics, halothane, enflurane, isoflurane, and sevoflurane, on chlorzoxazone metabolism in rabbits receiving artificial ventilation.
Results: All four inhalational anaesthetics decreased arterial blood pressure and increased plasma chlorzoxazone concentration. However, no significant differences in the plasma chlorzoxazone concentration were found between the four anaesthetics. The estimated chlorzoxazone clearance increased after beginning inhalation with all four agents, but no significant difference in clearance was noted between agents.
Conclusions: At therapeutic concentrations, the in vivo inhibitory effect on chlorzoxazone metabolism was similar for all four inhalational anaesthetics examined, even though their chemical characteristics and extent of hepatic metabolism differ considerably.