老年2型糖尿病患者双重任务行走步态特征与衰弱的相关性分析

目的了解老年2型糖尿病患者衰弱的发生情况及衰弱状态与双重任务行走步态特征的关系。方法方便抽取老年2型糖尿病患者189例,采用Fried衰弱表型量表评估其衰弱情况,便携式步态分析仪采集双重任务行走状态下的步态参数。结果 189例老年2型糖尿病患者无衰弱、衰弱前期、衰弱分别为30.69%、51.32%、17.99%;与非衰弱患者比较,衰弱前期及衰弱患者步速减慢、步频及步长减少、跨步时间延长(均P0.05);步速、步频及步长与衰弱程度呈负相关,跨步时间与衰弱程度呈正相关(均P0.01)。结论老年2型糖尿病患者衰弱发生率较高,衰弱患者的步态性能恶化较衰弱前期及无衰弱者更加明显,应关注衰弱患者的步态参数,避免出现跌倒等更严重的结局。     

双重任务和步行速度对慢性踝关节不稳患者步态变异性的影响

目的探讨双重任务和步行速度对慢性踝关节不稳定(chronic ankle instability,CAI)患者步态变异性的影响。方法选取我院2015年1月至2016年9月间诊治的16例患者,均有慢性踝关节不稳定症状,同时招募了16例年龄、性别相匹配的健康人作为对照组,在跑步机上测量在自定步速行走、双重任务自定步速行走、快速行走和双重任务快速行走四种不同条件下的步频的变异系数(stride time variability,STV)和步长的变异系数(stride length variability,SLV)。结果在自定步速行走(无双重任务)下,CAI和对照组的STV差异无统计学意义(P=0.346)。在健康对照组中,与自定步速行走模式下的STV相比,健康对照组人群的双重任务自定步速行走、快速行走及双重任务快速行走模式下的STV都降低(P值分别为0.011、0.016和0.001)。在CAI组中,与自定步速行走模式下的STV进行比较,只有双重任务快速行走模式下的STV降低(P=0.008)。两组受试者在四种不同行走模式下的SLV差异均无统计学意义。结论 CAI和健康受试者在挑战性的行走条件下均减少了步幅时间的可变性,但变化模式不同。与健康受试者相比,CAI患者出现因更高程度的步态障碍(概念混乱,应是"行走条件")导致其步态模式的改变,表明CIA患者感觉系统的适应性较低。     

双重任务训练对养老院老年人步态与平衡功能的影响

目的 探讨双重任务训练对养老院老年人步态与平衡改善的效果。 方法 将养老院30例老年人按照随机数字表法分为观察组与对照组各15人。对照组按常规进行回春医疗保健操训练，观察组在常规训练基础上开展双重任务训练。于干预前和干预6周后进行步态参数测试及平衡测试。 结果 干预后，观察组步速、步长、双重任务步长、起立行走试验用时和双重任务起立行走试验用时、平衡功能评分显著优于对照组（P＜0.05，P＜0.01），两组双重任务步速及ABC平衡信心评分差异无统计学意义（均P＞0.05）。 结论 双重任务训练可改善养老院老年人的步态及综合平衡能力，但对其害怕跌倒心理的改善作用不显著。     

社区老年人双重任务行走步态特征与跌倒的关系研究

目的探索社区老年人双重任务行走步态参数与过去一年跌倒史的关系。方法方便抽取135名社区老年人,根据过去一年有无跌倒史分为跌倒组(23名)与未跌倒组(112名)。运用问卷和便携式步态分析仪分别采集老年人一般信息、健康资料与10m双重任务行走步态参数。结果两组居住方式、家庭人均月收入及TUGT比较,差异有统计学意义(均P0.05);两组单脚支撑时间、单脚支撑时间/双脚支撑时间、步幅持续时间、周期时间、地面冲击、落脚强度、离地时脚的角度、速度与步频比较,差异有统计学意义(P0.05,P0.01)。结论双重任务行走时步态性能较差的社区老年人易发生跌倒。政府应加强公共活动场所的安全基础建设,鼓励老年人加强腿部肌肉锻炼和双重任务训练;医务人员应重视对老年患者步态的评估和功能锻炼,提高老年人行走能力,以预防跌倒发生。     

社区高龄老年人衰弱状况及影响因素的研究

目的调查社区高龄老年人衰弱现况,并对其影响因素进行探讨,为后期干预研究提供参考。方法采用方便抽样法,选取重庆市社区高龄老年人(≥80岁)272名作为研究对象。采用基本情况调查表、健康状况调查表、日常生活活动能力量表(ADL)、简易营养评价精法(MNA-SF)、简易智能状态检查量表(MMSE)和简明老年抑郁量表(GDS-5)进行调查,运用衰弱表型评估法进行衰弱筛查。结果 272名社区高龄老年人中,80名(29.4%)为衰弱,112名(41.2%)为衰弱前期,80名(29.4%)为无衰弱,握力减弱、行走速度减慢是发生最多的2个衰弱指标。有序Logistic回归分析结果显示,体育锻炼频率、多种用药、使用步行辅助工具、ADL、营养状态、抑郁情绪是影响社区高龄老年人衰弱的重要因素(P0.05,P0.01)。结论社区高龄老年人衰弱、衰弱前期发生率高,医护人员应重视社区高龄老年人衰弱、衰弱前期的早期筛查,并进行针对性干预。     

便携式步态分析仪对高弓足步态初步分析

目的采用便携式步态分析仪(PMA)收集高弓足及正常受试者的步态数据,比较并初步分析高弓足患者的步态特点。方法前瞻性收集自2014-01—2014-09诊治的高弓足20例(高弓足组),同期收集正常受试者20例(正常组)。记录并比较2组PMA测量的13项基本参数。结果与正常组比较,高弓足组单腿支撑时间、双腿支撑时间、步态周期时间、肢体摆动时间、步幅持续时间明显延长,抬腿力量、蹬地力量、跖屈力量、步速、步频明显降低,差异均有统计学意义(P0.05)。2组摆动力量、步长和步幅差异无统计学意义(P0.05)。结论高弓足患者行走时,存在行走时间延长、跖屈和蹬地力量降低的特点;而PMA评估步态安全、便捷、准确。     

社区老年人衰弱状况与抑郁症状关系的研究

目的了解社区老年人衰弱状况与抑郁症状关系,为社区老年人心理健康管理提供参考。方法采用方便抽样对683名60岁及以上北京市社区老年人进行横断面调查,调查工具包括一般资料调查表、简明老年抑郁量表、日常生活活动能力量表及衰弱状况通过Fried的衰弱表型法进行划分。结果调查对象中抑郁症状发生率为19.9%,衰弱前期和衰弱的发生率分别为45.7%和11.1%;衰弱状况与抑郁症状呈正相关(P0.01);排除混杂因素后,衰弱前期和衰弱的社区老年人发生抑郁症状的风险高于其他老年人(均P0.01)。结论衰弱前期和衰弱的老年人是抑郁症状发生的高危人群,可通过多方面的衰弱管理进行抑郁症状的预防与干预,促进社区老年人身心健康。     

骨水泥与生物型假体半髋关节置换在治疗老年骨质疏松相关股骨颈骨折术后早期步态对比分析

目的 运用步态分析技术比较骨水泥与生物型半髋假体在治疗老年骨质疏松相关股骨颈骨折术后早期不同时间段的步态变化,探讨两种假体植入术后早期的康复效果。方法 通过分析2021年1月至2022年1月于河北省沧州中西医结合医院髋部创伤科半髋关节置换的患者资料,共60例;后外侧入路骨水泥假体半髋关节置换手术（30例）,后外侧入路生物型假体半髋关节置换手术（30例）。采用步态分析技术比较每组患者术后1、3、6个月的行走时步长、步速、步频、行走时髋关节活动度的改善情况及两组患者之间的差异,以及两组患者术后1、3、6个月改良髋关节（MHHS）评分变化。结果 两组患者的步长、步速、步频、髋关节外展活动度在术后3、6个月检测结果较术后1个月改善明显（P<0.05）。术后1、3个月时,骨水泥假体组患者的行走时步长、步频、步速、髋关节外展活动度检测结果优于生物型假体组（P<0.05）;术后6个月时,两组各指标比较差异无统计学意义（P>0.05）。骨水泥型假体组与生物型假体组术后1、3、6个月的改良Harris评分差异无统计学意义（P>0.05）。但两组的术后3、6个月的MHHS评分均比术...     

股骨偏心距对全髋关节置换术后步态的影响

目的探讨人工全髋关节置换术后股骨偏心距对行走过程中术侧下肢步态时间距离参数的影响。方法按入组标准对2000年1月—2005年12月于我院行单侧人工全髋关节置换术后患者29例58髋进行标准骨盆正位X线片检查,测量双侧股骨偏心距,计算股骨偏心距比(femoraloffsetratio,FOR)。行三维步态分析,采集步态时间距离参数。根据FOR分组并对双侧下肢的各项数据进行统计学分析。结果手术侧FOR小于对侧为A组,共10例,手术侧单腿站立相、踏步时间及跨距与对侧比较,差异有统计学意义(P0.05);分别对双侧下肢的步频、步速、跨步时间、踏步距离及双腿支撑时间进行比较,差异无统计学意义(P0.05);手术侧FOR大于对侧为B组,共19例,双侧下肢各项步态时间距离参数差异均无统计学意义(P0.05)。结论人工全髋关节置换术后术侧股骨偏心距不足对患者步态具有重要影响;人工全髋关节置换术中重建股骨偏心距有助于髋关节生物力学的恢复和术后步态的改善。     

针刀配合中医正骨手法治疗拇外翻的临床效果

目的 探讨针刀配合中医正骨手法治疗拇外翻的临床疗效及对患者步态变化的影响。方法:选取2020年8月—2021年4月收治的60例符合病例选择标准的拇外翻患者,随机分为观察组和对照组各30例。其中对照组给予微创手术截骨治疗,观察组进行针刀配合中医正骨手法进行治疗。对比两组治疗前后美国足踝外科协会(AOFAS)评分、拇外翻角(HVA)及临床疗效,采用步态分析中时空参数(步长、步速、步频及步宽)评估患者步态变化。结果:两组术后3个月、1年AOFAS中功能、疼痛、对线评分均高于术前,差异有统计学意义(P＜0.05),术后1年各项评分均高于术后3个月,差异有统计学意义(P＜0.05),观察组术后3个月、1年各项评分均高于对照组,差异有统计学意义(P＜0.05);两组术后3个月、1年的HVA均较术前降低,差异有统计学意义(P＜0.05),术后3个月与术后1年比较无差异(P＞0.05),但观察组术后3个月、1年的HVA均更低,差异有统计学意义(P＜0.05);术后3个月,观察组优良率高于对照组,差异有统计学意义(P＜0.05);两组术后3个月、1年的步长、步速、步频均大于术前,且观察组术后3个月、1年均高于对照组,差异有统计学意义(P＜0.05);步宽均小于术前,差异有统计学意义(P＜0.05),且观察组术后3个月、1年均小于对照组,差异有统计学意义(P＜0.05)。结论:针刀配合中医正骨手法治疗拇外翻能改善拇外翻畸形症状,改善患者步态,疗效显著。     

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.