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Purpose: To compare the haemodynamic responses to surgical incision during sevoflurane and isoflurane anaesthesia and to compare the haemodynamic effects of each anaesthetic alone with those obtained using an equipotent mixture of each anaesthetic plus N2O during steady-state surgical stimulation., Methods: Twenty-four patients undergoing gastrectomy were randomized to receive sevoflurane (n = 12) or isoflurane (n = 12). At 1.5 MAC, haemodynamic measurements were performed before and after surgical incision. During intestinal anastomosis, patients in each group were given (in random order) either 1.5 MAC of the designated anaesthetic or 0.85 MAC of the volatile plus 0.65 MAC N2O. Haemodynamic measurements were repeated under each condition., Results: One patient in the sevoflurane group and two in the isoflurane group were excluded from the incision study because of hypotension. In both groups, incision increased the heart rate (HR), mean arterial pressure, mean pulmonary arterial pressure (MPAP), pulmonary capillary wedge pressure (PCWP), cardiac index, and systemic vascular resistance index (SVRI). There were no intergroup differences in the effects of incision. Inclusion of N2O resulted in an increase of MPAP (P < 0.05) in both groups, an increase of central venous pressure and PCWP in the sevoflurane group (P < 0.005), and a decrease of HR (P < 0.005) and an increase of SVRI (P < 0.05) in the isoflurane group. There were no intergroup differences in the effects of N2O., Conclusions: At 1.5 MAC, sevoflurane and isoflurane do not prevent the haemodynamic response to incision. The haemodynamic effects of each volatile anaesthetic with N2O are minimal compared with those of equi-MAC volatile alone.

Changes of glucose tolerance after partial pancreatectomy were divided into three types depending on the extent of resection. When 88 per cent or more of the pancreas was resected, hyperglycemia developed immediately, and when 70 to 88 per cent of the pancreas was resected, diabetes occurred after six weeks or more, but diabetes did not develop at all when less than 70 per cent of the pancreas was removed. The secretion of glucagon was maintained well, but that of insulin was easily impaired after resection of 70 per cent or more of the entire pancreas.

Changes of an exocrine function after major resection of the canine pancreas were observed by pancreozymin-secretin test and the results were compared with an endocrine function examined by glucose tolerance test. The exocrine function of the remnant pancreas revealed characteristic changes according to the resection rate of the pancreas: 1) After removal of 50 to 70 per cent of the entire pancreas, diabetes did not develop and the exocrine function of the remnant pancreas was well maintained. 2) After 70 to 90 per cent pancreatectomy, diabetes developed six weeks or more later and the exocrine function of the remnant pancreas per body weight decreased slightly. The degree of disturbance of the exocrine function in the diabetic dogs was greater than that in the non-diabetic group, but the exocrine function per the remnant pancreas weight increased and it was greater than normal level even in the diabetic dogs. The hypersecretory state of the exocrine pancreas after surgery was verified. 3) After 90 per cent or greater resection of the pancreas, diabetes occurred immediately and disturbance of the exocrine function was remarkable. Hypersecretory state did not appear. 4) Both the endocrine and exocrine functions after major pancreatic resection were found to be related to the resection rate, but there were significant differences in the reserve capacity of the endocrine and exocrine pancreas.