麻酔薬および麻酔関連薬使用ガイドライン 第3版 …

1 Nitrous oxide 280 fentanyl citrate 339. adrenaline 283 . alprostadil bupivacaine hydrochloride hydrate 343. alprostadil alfadex 287 . isoflurane 290 buprenorphine hydrochloride 346. ephedrine hydrochloride 293 propofol 349. oxytocin 296 vecuronium bromide 352. ketamine hydrochloride 298 pentazocine . diazepam 301 pentazocine hydrochloride 355.. dinoprost midazolam 358. dinoprost tromethamine 304 methylergometrine maleate . sugammadex sodium 306 ergometrine maleate 361. metoclopramide . suxamethonium chloride hydrate 309 metoclopramide hydrochloride 362. sevoflurane 311 mepivacaine hydrochloride 364. desflurane 315 morphine hydrochloride hydrate . tetracaine hydrochloride 318 morphine sulfate hydrate 367. dopamine hydrochloride 320 lidocaine hydrochloride 371.

2 Droperidol 322 . nicardipine hydrochloride 325 magnesium sulfate hydrate 375. nitroglycerin 328 . barbiturates levobupivacaine hydrochloride 378. thiopental sodium . thiamylal sodium 332 remifentanil hydrochloride 382. hydralazine hydrochloride 334 rocuronium bromide 386.. phenylephrine hydrochloride 337 ropivacaine hydrochloride hydrate 390.. 3 5 .. 4 .. , .. 3 2012 - 2014 3 4 -1 279.. nitrous oxide .. 1. 1 / . 1 2 . 2.. 3.. 4. 2 5. MAC . 105 110 . 3 . 6.. 7. 4 . 8. 5 6 .. 9. 7 .. 10. 8 9 .. 11.. 12.. 13. 10 11 .. 14. 15.. 12 . 16. 13 .. 17. 3 18. 1000 mL/min . 20 30 19.. 20.. 21. 22.. 14 . 23. 24. 2 25. 1 26. 2 27. 28. 3 29. 20 . 1 30.. 30 . 31.. 100 5 . 32. 2 50 50 33. 34. 4 35. 1 36. B12 . B12 . 37.. B12 . 38.. 39.

3 40.. 41. 42. 43.. 44. 45. 2 .. 46. 47. 3 2012 3 2 -2 280.. 3 1.. 2. a 50 75 . 15 . 3. b . 4. 16 .. 5. c 75 6 17 . 6. d . 50 24 . 7. 18 . 8. 9. a . 7 6 . 10. 3 19 . 11. b 4 . 12. 20 . 13. c 14. 15. a . 5,700 16. 21 .. 17. b .. 18. 22 . 19. c 23,24 . 1 . 20. 2 7 . 21. 22. 3 23. 2 . 3 24. 25 .. 25.. 26. SpO2 . 26 . 27. 28. 5 29. -a -b 30. -c 31. 1 : NEW 1994, pp341-348 . 32. 2 : 11 1 : 1991, pp171-175 . 3 Eger El II, Saidman LJ, Brandstater B : Minimum alveolar anesthetic concentration : A standard of anesthetic potency. Anesthe- 33. siology 1965 ; 26 : 756-763 34. 4 Baskett PJ, Bennett JA : Pain relief in hospital : The more widespread use of nitrous oxide. Br Med J 1971 ; 29 : 509-511 -b 35. 5 Peterson DO, Drummond JC, Todd MM : The e ects of halothane, enflurane, isoflurane, and nitrous oxide on somatosensory 36.

4 Evoked potentials in humans. Anesthesiology 1986 ; 65 : 35-40 -c . 6 Smith AL, Wollman H : Cerebral blood flow and metabolism : Effects of anesthetic drugs and techniques. Anesthesiology 37. 1972 ; 36 : 378-400 -c 38. 7 Carton EG, Wanek LA, Housmans PR : E ects of nitrous oxide on contractility, relaxation and the intracellular calcium tran- 39. sient of isolated mammalian ventricular myocardium. J Phamacol Exp Ther 1991 ; 257 :843-849 -c . 40. 8 Smith NT, Eger El II, Stoelting RK, et al : The cardiovascular and sympathomimetic responses to the addition of nitrous oxide to halothane in man. Anesthesiology 1970 ; 32 : 410-421 -c 41. 9 Ebert TJ : Di erential e ects of nitrous oxide on baroreflex control of heart rate and peripheral sympathetic nerve activity in 42.

5 Humans. Anesthesiology 1990 ; 72 : 16-22 -c 43. 10 Forbes AR, Horrigan RW : Mucociliary flow in the trachea during anesthesia with enflurane, ether, nitrous oxide, and mor- 44. phine. Anesthesiology 1977 ; 46: 319-321 -c . 11 Hurtig JB, Tait AR, Loh L, et al : Reduction of hypoxic pulmonary vasoconstriction by nitrous oxide administration in the iso- 45. lated perfused cat lung. Can Anaesth Soc J 1977 ; 24 : 540-549 -c 46. 12 Hartung J : Twenty-four of twenty seven studies show a greater incidence of emesis associated with nitrous oxide. Anesth Analg 47. 1996 ; 83 : 114-116 -b . 48. 13 O Sullivan H, Jennings F, Ward K, et al : Human bone marrow biochemical function and megaloblastic hematopoiesis after ni- trous oxide anesthesia.

6 Anesthesiology 1981 ; 55 : 645-649 -c 49. 14 Drummond JT, Matthews RG : Nitrous oxide degradation by cobalamin-dependent methionine synthase : Characterization of 50. the reactions and products in the inactivation reaction. Biochemistry 1994 ; 33 : 3732-3741 -c 51. 3 2012 3 2 -3 281.. 15 Shepard TH,Fink BR : Teratogenic activity of nitrous oxide in rat. In Fink BR : Toxcity of Anesthetics. Baltimore, Williams and 1. Wilkins, 1968, p308 2. 16 Vieira E, Cleaton-Jones P, Austin JC, et al : E ect of low concentration of nitrous oxide on rat fetuses. Anesth Analg 1980 ; 59 : 3. 157-177 . 17 Mazze RI, Fujinaga M, Rice SA, et al : Reproduction and teratogenic e ects of nitrous oxide, halothane, isoflurane and enflurane 4. in Sprague-Dawley rats.

7 Anesthesiology 1968 ; 64 : 339 5. 18 Mazze RI, Fujinaga M, Baden JM : Reproductive and teratogenic effects of nitrous oxide,fentanyl and their combination in 6. Sprague-Dawley rats. Br J Anaesth 1978 ; 59 : 1291 . 7. 19 Jevtovic-Todorovic V, Hartman RE, Izumi Y, at al : Early exposure to common anesthetic agents causes widespread neurodegen- eration in the developing rat brain and persistent learning deficits. J Neurosci 2003 ; 23 : 876 8. 20 MacClaine RJ, Uemura K, de la Fuente SG, et al : General anesthesia improves fetal cerebral oxygenation without evidence of 9. subsequent neuronal injury. J Cereb Blood Flow Metab 2005 ; 25 : 1060 10. 21 Pharoah PO, Alberman E, Doyle P, et al : Outcome of pregnancy among Women in anaesthetic practice.

8 Lancet 1977 ; 1 : 34. 11. -b . 22 Gauger VT, Voepel-Lewis T, Rubin P et al : A survey of obstetric complication and pregnancy outcome in paediatric and non- 12. paediatric anaesthesiologists. Paediatr Anaesth 2003 ; 13 : 490 -b 13. 23 Brodsky JB, Choen EN, Brown BW : Surjery during pregnancy and fetal outcome. Am J Obstet Gynecol 1980 ; 138 : 1165 -b 14. 24 Mazze RI, Kallen B : Reproductive outcome after anesthesia and operation during pregnancy : A registry study of 5405 cases. 15. Am J Obstet Gynecol 1989 ; 161 : 1178 -b . 25 Shinder SM, Webster GM : Matrnal and fetal hazards of surgery. Am J Obstet Gynecol 1965 ; 92 : 891 -b 16. 26 Irestedt L : Current status of nitrous oxide for obstetric pain relief. Acta Anaesthesiol Scand 1994 ; 38 : 771 17.

9 18. 19. 20. 21. 22. 23. 24. 25. 26. 27. 28. 29. 30. 31. 32. 33. 34. 35. 36. 37. 38. 39. 40. 41. 42. 43. 44. 45. 46. 47. 48. 49. 50. 51. 3 2012 3 2 -4 282.. adrenaline epinephrine .. 1. 1 2. 2 3. 1 .. 4.. 5.. 6.. 7. 2 .. 8.. 9.. 10. 11. 12.. 13.. 14. 2 . 15. 3 16. - - . 17. 18.. - - - 19. 20. 4 . 21.. 22. 2,3 4,5 .. 23.. 24.. 25. 2 .. 5 9 . 26. 30 . mg/mL 30 . 27. 10 . 28.. 29. ST . 30. 20 . 31. mg/mL .. 32. 11,12 .. 33. 34. 5,6 . 35. 36. 2 37. 6 . 8 . 9 38.. 39. 1 .. 40. 1 .. 41. 42. 13 . 2 . 43.. 44. 3 45. 4 1 . 13 .. 46. 13 . 5 .. 47. 3 2012 - 2014 3 4 -5 283.. 1.. 6 14 . 2. 15 . 7 .. 3. 4. 16,17 . 8 5. T 6. 7. 9 .. 8.. 9. 10. 3 . 11. 1 0 . 13 . 01 mg/kg 1000 1mg/mL . 3 20 . 12. 2 13 0 . 3 0 5 mg 1000 1 mg/mL 15 20 0 1 mg 1.

10 13. mg/mL . 5 . 1 4 g/min . 14.. 15. 3 1 g/min .. 16. 4 13 2 10 g/min .. 17. 5 13 .. 18. 1 1 mg 1 mL 20 mL . 19. 3 5 . 20. 2 2 . 5 5 10 mL . 21.. 22. 0 . 01 0 03 mg/kg 3 5 . 23. 6 15 0 . 1 1 mg/mL 20 5 g/mL .. 24.. 1000 . 1 mg/mL . 5000 . mg/mL .. 25.. 26. 7 16,17 0 . 1 . 20 mL 0 . 1 mL 20 . 27. 5 g/mL 2 3 mL .. 28. 8 20 5 g/mL . 29. 80 g/mL .. 30. 1 100 g 100 g/hr .. 31. mL mg 200 g . 1/10. 32.. 33.. 34. 35. 4 . 36. 1 .. 37.. 38. 2 . 39. pH pH . 40. 11,12 . 18 .. 41.. 42.. 43.. 44. 19 .. 45. 20 . 46.. 47.. 48. 21 .. 49.. 50.. 51. 3 2012 - 2014 3 4 -6 284.. 3 22 . 1.. 2.. 3.. 4. 5.. 6. 4 7.. 8.. 9. 23 .. 10.. 11. 24 . 12.. 13.. 14.. 15.. 16. 17.. 18.. 19. 6 . 20.. 21. 22. 7 23. 24. T .. 25.. 26. 27. 5 28. -a -b 29. -c 30.