Diethyl Ether 마취의 실험적 연구

Abstract

[한글]

[영문]

Diethyl ether was first described by Valerius Cordus in 1540, and it is generally

agreed that Crawford Long used ether for 3 surgical patients in 1842, and Morton

subsequently gave a definitive public demonstration in Boston in October, 1846.

After this, ether used became widely published and the news spread to London, where

Drs. Boot and Squires soon used it on surgical cases at University College

Hospital. The importance and volume of diethyl other in the anesthesia field grew

day by day and year by year after Crawford Long and Morton, and it is widely used

by various techniques.

But, during the past decade, the frequency of usage of diethyl ether has declined

and it is now hard to find new articles on diethyl ether. The reason is that the

experience of induction is most unpleasant and stormy with secretions, vomiting and

laryngospas also, excessive depth is often produced and in the post operative

course, headache, nausea, vomiting, and fluid or electrolyte disorders may follow.

Another reason is the production of various new inhalation anesthetics.

Today, many serious complications of new anesthetics are report especially

halothane may have a hepato-sensitive effect (Burnap 1958 Virtus 1958, Barton 1959,

Temple 1962, and Bunker 1963), and new recent articles about ether were published

by McArdle (1968), Oyama (1969) and Markello (1969).

It should also be remembered that, although its use in clinical practice in

Britain and other western parts is now almost as limited as chloroform, ether is

still the main inhalational anesthetic in many parts of the world, because diethyl

ether is an excellent anesthetic safer and perhaps more inexpensive than any other.

since diethyl ether has recently been produced in Korea, objectives of the study

were mainly reevaluation of the effects of diethyl ether through experimental

animal studies.

Nine healthy normal dogs weighing approximately 10 kg. body weight were employed

in this experiment and 4 dogs anesthetized with Squibb ether and 5 dogs with Korea

made ether, were used for the study. Endotrachcal intubation was done under light

sedation with pentobarbital sodium 30 mg/kg I.V. and the tube connected with a

Ruben valve; Nonrebreathing system which could be applied 023 to 0.5L/min. through

the Heidbrink Ohio Chemical Anesthesia Aparatus without any anesthetics.

Cannulations were applied into the right jugular vein for C.V.P, into the femoral

artery for arterial pressure, the femoral vein for fluid infusion which contained

Inulin and B.S.P. (priming doses were 50mg/kg and 5mg/kg and maintenance doses were

0.25mg/kg/min. and 0.05mg/kg/min.) using the Harvard infusion pump (2 ml/min.), the

other femoral artery for blood sampling, both ureters for urine collection, and the

common bile duct for bile collection.

A Polygraph Grass Type 4 Channel Machine was connected for E.E.G., E.C.G,, C.V.P.

and arterial pressure.

During the whole of the study, E.E.G., E.C.G., arterial pressure, C.V.P. and

arterial blood sampling for PaCO^^2, PaO^^2, pH and hemoglobin, and urine

collection for Inulin clearance, and bile collection for B.S.P. clearance, was done

every 20 minutes through a 4 hours (one hour for the pre-anesthetic period, two

hours for the anesthesia period, and one hour for the post-anesthetic period).

Arterial blood gas, and pH were analyzed with a Radiometer, hemoglobin by the

hemophotometer, Inulin clearance by the Schreiner method, and B.S.P. clearance by

the Pitt aceton method.

After the post-anesthetic period, tissue specimens; the heart, lung, liver and

kidney, were fixed in 10% formalin and stained with hematoxylin and eosin, and PAS.

stain for histopathological study. Result and Summary

An E.C.G. tracing with pulse rate, arterial pressure, and C.V.P. were not changed

significantly during ether anesthesia in dogs.

Within the first 60 minutes during other anesthesia, PaO^^2 were elevated but

after that gradually declined until post-anesthetic period. PaCO^^2, pH and

hemoglobin values did not show any remarkable change in all experiments.

B.S.P. and Inulin clearances during ether anesthesia were decreased but recovered

slightly in the post-anesthetic period.

Histopathologically, in a few dogs, a slight alveolar edema, capillary

congestion, alveolar wall thickening, mucosal degeneration, destruction of

bronchioles in the lung and glomcrular ischemic changes in the kidney were observe.

No other pathological findings in the heart and liver were found.