急性腹透相关性腹膜炎患者超滤和溶质转运的变化

目的：研究持续非卧床腹膜透析（CAPD）患者发生急性腹透相关性腹膜炎时腹膜超滤功能、腹膜对小分子物质转运的变化，以及急性腹膜炎对患者血清白蛋白的影响。方法：对2006年1月～2008年3月期间因腹透相关性腹膜炎住院的22例CAPD患者（男12例，女10例）进行研究，收集腹膜炎发生后第1、3、6、9、12天的血和腹透液标本，分别检测血和腹透液常规及肌酐、糖、白蛋白、Na^＋、K^＋。同时记录每天腹透超滤量，并查看患者腹膜炎发生前最后一次的腹膜平衡试验（PET）结果和腹膜炎发生前2周每日超滤量并计算其均值，分别作为腹膜炎发生后腹膜对肌酐转运及腹膜超滤情况的基线对照组。腹膜溶质转运的计算通过同一时间点该溶质腹透液与血浆的比值（D／P）测得。结果：与腹膜炎发生前腹透超滤量相比，腹膜炎发生后第1、3天超滤量明显减少，呈负超滤（P〈0．01）；腹膜炎发生后各时间点肌酐D／P值均较腹膜炎发生前肌酐D／P值明显升高（P〈0．05）；腹膜炎发生后第3、6、9、12天血清白蛋白水平明显低于腹膜炎发生第1天（P〈0．05）。结论：CAPD合并急性腹膜炎时腹膜超滤功能降低，尤以腹膜炎早期更明显；急性腹膜炎导致腹膜对肌酐的转运增加及患者的血清白蛋白水平降低。     

肾移植早期尿淋巴细胞表型分析的应用价值

目的：探讨尿淋巴细胞表型分析在肾移植早期免疫监测中的临床应用价值。方法：以流式细胞技术对37例肾脏移植患者的105份尿样本进行尿淋巴细胞表型分析,测定CD3、CD4、CD8、CD19、CD25、HLA－DR阳性细胞百分率,其结果在急性排斥反应组和肾功能稳定组之间进行比较。结果：与肾功能稳定组比较,急性排斥反应组尿淋巴细胞表达HLA－DR数增多非常显著（P＜0．01）,CD8和CD25细胞增多显著（P＜0．05）,而CD3、CD4、CD19细胞数变化不显著（P＞0．05）。在诊断移植肾急性排斥反应上,HLA－DR阳性样本的诊断敏感性和特异性分别达86．96％和90．24％,CD8和CD25阳性标本的阴性预测值分别达86．79％和85．71％。结论：尿淋巴细胞表型分析可间接反映出移植肾内的免疫状态,是诊断和鉴别诊断移植肾急性排斥反应的有效方法,适用于肾移植早期的免疫监测。     

脑源性神经营养因子与腹膜透析患者认知功能障碍的相关性分析

目的：探讨脑源性神经营养因子（BDNF）与持续性非卧床腹膜透析（CAPD）患者认知功能障碍的相关性。方法：以CAPD患者为研究对象,采用中文版蒙特利尔认知评估量表（MoCA）调查其认知功能,并检测血清BDNP水平,采用相关分析法探讨CAPD患者认知功能与BDNP的相关性。结果：（1）98例CAPD患者中伴有认知功能障碍者58例,占59．18％。（2）CAPD组MoCA总分、注意力、延迟回忆和抽象评分显著低于健康对照组,差异均有统计学意义（P＜0．05）。（3）CAPD伴认知功能障碍组和CAPD不伴认知功能障碍组的BDNF均显著低于健康对照组,差异有统计学意义（P＜0．01）;CAPD伴认知功能障碍组的BDNF显著低于CAPD不伴认知功能障碍组,差异有统计学意义（P＜0．01）。（4）血清BDNF与MoCA总分、注意力、延迟回忆和抽象均显著正相关（P＜0．05）。结论：CAPD患者认知功能障碍患病率较高,BDNF可能与CAPD患者认知功能障碍有美．     

尿流式细胞学在诊断移植肾急性排斥反应中的应用价值

目的：探讨尿流式细胞学在诊断移植肾急性排斥反应中的临床应用价值。方法：对43例肾移植受者的116份尿样本进行尿流式细胞学分析，并将急性排斥组和肾功能稳定组的分析结果进行比较。结果：急性排斥反应组尿淋巴细胞总数以及HLA－DR^ 淋巴细胞数显著增多，与肾功能稳定组比较，P＜0．01，CD8^ 细胞亦增多（P＜0．05），而CD3^ ,CD4^ ,CD19^ 细胞数变化两组差异不显著（P＞0．05），在诊断移植肾急性排斥反应上，HLA－DR阳性样本和淋巴细胞数阳性样本的诊断敏感性和特异性分别达95．2％，90．5％，和92．6％，87．4％，结论：尿流式细胞学分析可反映移植肾内的免疫状态，尿淋巴细胞数的显著增多和尿HLA－DR^ 淋巴细胞增多可以作为诊断急性排斥反应的有意义指标。     

提高腹膜透析相关感染性腹膜炎致病菌培养阳性率的方法学研究

目的探讨改进腹膜透析相关感染性腹膜炎透出液致病菌的培养方法,提高病原菌的培养阳性率。方法收集27例患者45例次腹膜炎透出液标本。腹膜炎患者透出液同时按以下6组方法分别进行致病菌培养：传统平板法、离心平板法、BacT/Alert培养瓶法（PF瓶法、SA瓶法、SN瓶法）和冻融法。结果离心平板组阳性率高于传统平板组,差异具统计学意义（60．0％比44．4％,P＜0．05）;与离心平板组相比,PF瓶组（84．4％）、SA瓶组（82．2％）和SN瓶组（82．2％）阳性率均提高（P均＜0．01）。在检测致病菌生长所需时间（TDG）方面,与离心平板组[（24．31±9．80）h]相比,PF瓶组[（14．25±9．13）h]、SA瓶组[（12．75±7．47） h]和SN瓶组[（9．79±4．14）h]的TDG均缩短（P均＜0．01）;SN瓶组的TDG比PF瓶组和SA瓶组更显著缩短（P均＜0．01）。结论离心法能显著提高培养阳性率。BacT/Alert培养系统与普通平板技术相比,能显著提高培养阳性率并缩短检测致病菌生长所需时间。SN培养瓶法检测致病菌生长所需时间最短。     

CD44v6在甲状腺癌组织中的表达及其意义

目的 探讨甲状腺癌组织中CD44v6抗原的表达及其临床意义。方法 应用微波－ISAB免疫组织学法，检测50例甲状腺癌、45例甲状腺瘤和20例癌旁状腺组织中CD44v6的表达。结果 甲状腺癌中CD44v6表达阳性率（64．0％）显著高于甲状腺腺瘤（37．0％）和癌旁甲状腺组织（25．．0％（均P＜0．05）。CD44v6表达与甲状腺癌组织类型无关；CD44v6表达阳性率在淋巴结转移者显著高于无淋巴结转移者（P＜0．05）；病理分期Ⅲ－Ⅳ期病例显著高于病理分期Ⅰ－Ⅱ期病例（P＜0．05）。CD44v6阳性的甲状腺癌复发及死亡率显著高于CD44v6阴性者（P＜0．05）。结论 CD44v66表达对甲状腺癌恶性程度判断、生物学行为预测和预后评估是一种有意义的客观指标。     

不同钙浓度腹透液对尿毒症患者颈动脉粥样硬化影响的超声评价及相关因素分析

目的：观察使用不同钙浓度腹透液行持续性不卧床腹膜透析（CAPD）的尿毒症患者颈动脉粥样硬化的超声学改变。并行相关因素分析。方法：将40例初行CAPD的尿毒症患者随机分为2组：标准钙腹透液治疗组（A组，20例）和低钙腹透液治疗组（B组，20例），行正规CAPD治疗并配合碳酸钙口服。观察治疗12个月前后患者颈动脉内-中膜厚度（IMT）、颈动脉粥样斑块数量和超声分型的变化，以及血清钙、磷、钙磷乘积、甲状旁腺素（iPTH）的改变。结果：两组患者初行CAPD治疗前颈动脉IMT、粥样斑块的数量、检出率和超声分型无差异。经过12个月的治疗随访后，B组患者颈动脉IMT、斑块发生率及溃疡斑的检出率显著低于A组（P〈0．05）。与此同时，B组患者的血清钙、磷及钙磷乘积也有着显著意义地降低（P〈0．05或P〈0．01），且均低于治疗后的同期A组患者（P〈0．05或P〈0．01），iPTH则有显著意义地上升（P〈0．01）。整个治疗过程中，两组患者均未有明显低钙抽搐、低血压等情况发生。结论：钙磷代谢紊乱可加重尿毒症CAPD患者的血管损伤，低钙透析液有助于减轻患者的钙磷代谢紊乱，减轻其对血管损伤，延缓颈动脉粥样硬化的进展。     

细胞粘附分子CD44v6表达与大肠癌临床及预后的关系

目的：研究大肠癌组织中的细胞粘附分子CD44v6表达及反应强度与肿瘤发生,分化、转移和预后的关系。方法：应用免疫组化法和计算机图象分析技术,对90例大肠癌组织进行CD44v6表达和反应强度定量检测,并对其中53例患进行随访。结果：68例大肠癌呈CD44v6阳性表达（75．6％）。CD44v6阳性物质主要分布于大肠癌细胞细胞膜和细胞质,图像分析,CD44v6阳性细胞平均积分光密度值在代分化腺癌显高于高,中分化腺癌和粘液腺癌（P＜0．05）,伴有浆膜浸润和淋巴结转移显高于无浆膜浸润和无淋巴结转移（P＜0．05）,在获得5年以上随访材料中,死亡病例显高于生存病例（P＜0．05）,结论：CD44v6反应强度在大肠癌发生,恶性程度,预测转移和客观估测患预后中具有着重要指导意义。     

Sialyl Lewis-X,CD44v6和E-cadherin表达与肝细胞癌转移和预后的关系

目的：探讨唾液酸化的路易斯寡酶－X（sialyl Lewis-X,SLeX)抗原，CD44v6和E－上皮钙粘附素（E－cadherin,ED)蛋白表达与肝细胞癌（HCC）转移和预后的关系。方法：应用免疫组织化学方法，检测110例HCC组织中SLeX,CD44v6及ED蛋白表达，结合随访资料分析。结果：在HCC中，SLeX,CD44v6和ED阳性表达率分别为39．1％（43／110），42．7％（47／110）和44．5％（49／110），SLeX和CD44v6阳性表达及ED阴性表达的HCC转移率高（P＜0．05），分化程度差和患者大于5年生存率低（P＜0．05），结论：SLeX,CD,44v6和ED表达与HCC转移和患者生成期密切相关，检测SLeX,CD44v6和ED蛋白的表达可作为判断HCC预后的参考指标。     

脑缺血耐受现象的临床研究

目的 探讨继发于短暂性脑缺血发作（TIA）的脑梗死是否存在缺血耐受现象。方法136例首次急性脑梗死患者分为有同侧TIA史的38例患者（有TIA组）及无同侧TIA史的98例患者（无TIA组）,测定两组患者入院时血小板活化因子（CD62P）阳性表达率,头颅MRI测量梗死面积,并评定其入院时及发病第30天的日常生活能力（ADL）评分。结果有TIA组患者入院时CD62P阳性表达率低于无TIA组[（4．21±0．43）％比（6．01±0．03）％,P〈0．05]：有TLA组患者梗死面积较无TIA组小（P〈0．05）。有TIA组患者发病第30天时ADL评分低于无TIA组[（21．12±1．45）分比（30．83±3．47）分,P〈0．05]结论继发于TIA的脑梗死存在缺血耐受现象。     

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.