Wiklund L
Acta Anaesthesiol Scand Suppl. 1975;58:5-28. doi: 10.1111/j.1399-6576.1975.tb05419.x.
Thirty-four patients with gallbladder disease, but otherwise healthy, were studied in connection with cholecystectomy. For postoperative analgesia, 22 patients were given a posterior splanchnic blockade with 0.5% plain lidocaine, and 12 were injected intramuscularly with fentanyl in a dose of 3.5 mug/kg b.w. Postoperatively, before administration of the analgesic agent, the cardiac output, mean arterial blood pressure, heart work and estimated hepatic blood flow were increased and the total peripheral resistance, splanchnic vascular resistance, arterial oxygen tension and base excess values were decreased. Fentanyl, in addition to its analgesic effect, also decreased the arterial oxygen tension and pH and increased the arterial carbon dioxide tension. There was little change in cardiac output, mean arterial blood pressure and estimated hepatic blood flow. Following splanchnic blockade, on the other hand, pain relief was accompanied by a decrease in cardiac output, mean arterial blood pressure and heart work to about the preoperative level, while the estimated hepatic blood flow remained unchanged and the splanchnic vascular resistance decreased rapidly. Neither total peripheral resistance nor blood gases altered as a result of splanchnic blockade.
对34例患有胆囊疾病但其他方面健康的患者进行了与胆囊切除术相关的研究。为进行术后镇痛，22例患者接受了用0.5%普通利多卡因进行的内脏神经后支阻滞，12例患者肌肉注射了剂量为3.5微克/千克体重的芬太尼。术后，在给予镇痛剂之前，心输出量、平均动脉血压、心脏做功和估计的肝血流量增加，而总外周阻力、内脏血管阻力、动脉血氧分压和碱剩余值降低。芬太尼除了具有镇痛作用外，还降低了动脉血氧分压和pH值，并增加了动脉血二氧化碳分压。心输出量、平均动脉血压和估计的肝血流量几乎没有变化。另一方面，在内脏神经阻滞后，疼痛缓解伴随着心输出量、平均动脉血压和心脏做功降至术前水平左右，而估计的肝血流量保持不变，内脏血管阻力迅速下降。内脏神经阻滞未导致总外周阻力和血气发生改变。
