Iida H, Ohata H, Iida M, Watanabe Y, Nagase K, Dohi S
Department of Anesthesiology and Critical Care Medicine, Gifu University School of Medicine, Gifu City, Japan.
Anesth Analg. 1999 Dec;89(6):1510-3. doi: 10.1097/00000539-199912000-00036.
Ropivacaine constricts spinal vessels. Because the CO2 response of spinal vessels is similar to that of cerebral vessels, we tested to see if hypocapnia would cause further spinal vasoconstriction during ropivacaine administration. In 12 pentobarbital-anesthetized dogs, spinal pial arteriolar diameter was measured using a closed spinal window preparation. Either ropivacaine solution (0.1%; n = 6) or artificial cerebrospinal fluid (n = 6) was infused continuously into the spinal window. After a period of hypocapnia (Paco2, 20-25 mm Hg) had been induced, inspired CO2 levels were adjusted to produce normocapnia (35-40 mm Hg) followed by hypercapnia (55-60 mm Hg). When the desired Paco2 was reached, measurements were made of the arteriolar diameter and physiological variables. During normocapnia, ropivacaine infusion produced a significant constriction of pial arterioles, whereas artificial cerebrospinal fluid caused no change. Hypocapnia induced a much smaller (almost nonexistent) additional vasoconstriction in the ropivacaine group than in the control group (P < 0.01). The final hypercapnic vasodilation was somewhat greater during ropivacaine (P < 0.05 versus control group). Topical ropivacaine induced no change in hemodynamic variables. We conclude that hypocapnia of the magnitude tested did not cause further constriction in spinal vessels during spinal ropivacaine.
During topical application of the local anesthetic ropivacaine in dogs, hypocapnia (Paco2, 20-25 mm Hg) induced almost no additional constriction of spinal arterioles, and the hypercapnic vasodilation was maintained. These data suggest that an additional constriction in spinal vessels is unlikely when hypocapnia occurs during spinal ropivacaine.
罗哌卡因可使脊髓血管收缩。由于脊髓血管的二氧化碳反应与脑血管相似,我们测试了低碳酸血症在罗哌卡因给药期间是否会导致脊髓血管进一步收缩。在12只戊巴比妥麻醉的犬中,使用封闭脊髓窗制备方法测量脊髓软膜小动脉直径。将罗哌卡因溶液(0.1%;n = 6)或人工脑脊液(n = 6)持续注入脊髓窗。在诱导低碳酸血症(动脉血二氧化碳分压,20 - 25 mmHg)一段时间后,调整吸入二氧化碳水平以产生正常碳酸血症(35 - 40 mmHg),随后是高碳酸血症(55 - 60 mmHg)。当达到所需的动脉血二氧化碳分压时,测量小动脉直径和生理变量。在正常碳酸血症期间,罗哌卡因输注导致软膜小动脉显著收缩,而人工脑脊液则无变化。低碳酸血症在罗哌卡因组诱导的额外血管收缩比对照组小得多(几乎不存在)(P < 0.01)。最终的高碳酸血症性血管舒张在罗哌卡因期间稍大(与对照组相比,P < 0.05)。局部应用罗哌卡因未引起血流动力学变量变化。我们得出结论,所测试程度的低碳酸血症在脊髓应用罗哌卡因期间不会导致脊髓血管进一步收缩。
在犬局部应用局部麻醉药罗哌卡因期间,低碳酸血症(动脉血二氧化碳分压,20 - 25 mmHg)几乎不会诱导脊髓小动脉额外收缩,并且高碳酸血症性血管舒张得以维持。这些数据表明,在脊髓应用罗哌卡因期间发生低碳酸血症时,脊髓血管不太可能出现额外收缩。