麻酔と蘇生 Volume 55 Issue 1
published_at 2019-03-01

麻酔科開設以来50年間の麻酔管理と使用麻酔薬の変遷

Transition of Anesthesia Management and Anesthetics Used for 50 Years Since the Establishment of Anesthesiology Department in Hiroshima University
Yasuda Toshimichi
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Abstract
広島大学麻酔蘇生学教室は1967年1月に盛生倫夫が初代教授に就任し開講した。開講50周年を機に,麻酔科開設以来の麻酔管理に用いた麻酔薬の変遷を辿った。開講当初から1985年までは亜酸化窒素とハロタンを中心とした吸入麻酔薬の時代,1990年から2005年はエンフルラン,イソフルラン,セボフルランなどの吸入麻酔薬とフェンタニルの併用の時で,2010年からはプロポフォールとレミフェンタニルの全静脈麻酔あるいはセボフルランあるいはデスフルランとレミフェンタニル併用の時代であった。開講から1980年頃まではスキサメトニウムを主に使ったが,それ以降は非脱分極性筋弛緩薬であるパンクロニウムへ,そしてベクロニウムへ推移し,現在はロクロニウムが主流となっている。使用麻酔薬の変遷は麻酔薬の科学的な評価とそれらを使用する麻酔科医の考え方を反映していた。
Abstract
Department of Anesthesiology and Critical Care, Hiroshima University, started in January 1967 when Dr. Michio Morio became the first professor. With the 50th anniversary of the establishment of the department, the transition of the anesthetics used in our long history of anesthesia care was investigated since the beginning of the department. Inhalation anesthetics was mainly used in combination with nitrous oxide and halothane from the beginning to 1985. Inhalation anesthetics such as enflurane, isoflurane, sevoflurane and intravenous fentanyl were used from 1990 to 2005, and the total intravenous anesthesia by using propofol and remifentanil was introduced and used currently. Sevoflurane or desflurane combined with remifentanil was also a mainstream since 2010. From the beginning to 1980, suxamethonium was mainly used for muscle relaxation, followed by pancuronium thereafter and shifted to vecuronium and to rocuronium. The transition of anesthetics applied for clinical anesthesia in our department seemed to be reflecting the selection based on scientific validity.
Keywords
麻酔薬
吸入
静脈内
変遷
anesthetics
inhalation
intravenous
transition