山梨医科大学雑誌　第15巻1号　013-018(2000)

＜臨床研究＞開腹手術におけるアムリノンとドパミン又は
ドブタミン併用が末梢循環に与える影響

古屋敦司，野中明彦，樫本 温，
岩本竜一，熊澤光生

抄 録：我々は，開腹術手術において，アムリノン非投与群が中枢―末梢温度較差の増大を示すのに対し，アムリノン投与群は中枢―末梢温度較差の増大を抑制することをすでに報告している。今回，予定開腹術手術患者を対照とし，アムリノンにドパミン又はドブタミンを併用した際の末梢循環に与える影響を比較検討した。麻酔は全身麻酔と硬膜外麻酔とを併用した。導入後，アムリノンのみを投与した群をアムリノン群とし，導入後ドパミン又はドブタミンを投与し，その後アムリノンを投与した群をドパミン群，ドブタミン群とした。末梢皮膚血流量（中指），中枢（鼓膜）―末梢（示指）温度較差を測定した。アムリノン群では，中枢―末梢温度較差の増大は抑制された。ドパミン群，ドブタミン群でも，中枢―末梢温度較差の増大は抑制されたが，アムリノン群に比べ有意差はなかった。アムリノンは中枢―末梢温度較差増大を抑制し，皮膚血流を維持したが，ドパミン又はドブタミンの少量併用はそれらに有意な変化を与えなかった。

キーワード　アムリノン，ドパミン，ドブタミン，末梢循環



Effects of Amrinone Combined with Dopamine or Dobutamine on Peripheral Circulation during Major Abdominal Surgery

Atsushi FURUYA, Akihiko NONAKA, Satoshi KASHIMOTO, Ryuichi IWAMOTO and Teruo KUMAZAWA

Abstract: The effects of amrinone combined with dopamine or dobutamine on peripheral blood flow and temperature during abdominal surgery under general anesthesia were studied. Forty-eight elective patients were assigned to one of three groups as follows. Patients who received 3μg kg-1 min-1 of dopamine or dobutamine with amrinone were assigned to the dopamine and dobutamine groups, respectively. Patients who received only amrinone were assigned to the amrinone group. All patients received 1μg kg-1 of amrinone followed by 5μg kg-1 min-1 of amrinone. Tympanic membrane temperature, fingertip temperature and peripheral blood flow at fingertip were monitored continuously during surgery. Fingertip temperatures and tympanic membrane temperature in all groups tended to decrease but did not reach statistically significant levels 120 minutes after administration of amrinone. The tympanic membrane-fingertip temperature gradients and peripheral blood flow did not change significantly in any group. These results suggest that amrinone may be effective for maintaining central and peripheral temperatures and peripheral blood flow, and that the combination of dopamine or dobutamine did not alter the effect of amrinone on temperatures and blood flow during abdominal surgery under general anesthesia.

Key words: amrinone, dopamine, dobutamine, peripheral circulation



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