Takeda S
Department of Anesthesiology, Nippon Medical School, Tokyo.
Masui. 1992 Nov;41(11):1749-57.
The effect of epidural anesthesia on prostaglandin synthesis during alveolar hypoxia was investigated in 20 patients. Group I received intravenous anesthesia and group II received epidural and intravenous anesthesia. Patients in both groups were intubated with a double-lumen end tracheal tube, allowing separate ventilation of the right lung with 5% CO2, 6% O2 and 89% N2 as a hypoxic challenge and the left lung with 100% O2. In both groups, adequate systemic oxygenation was maintained. Pulmonary artery pressure and pulmonary vascular resistance increased significantly in both groups. Cardiac index decreased significantly in group II. Both 6-keto PGF1 alpha and thromboxane B2 increased in group I, but only 6-keto PGF1 alpha increased in group II. Hypoxic pulmonary vasoconstriction (HPV) stimulated prostaglandin synthesis. 6-keto PGF1 alpha is the major arachidonic acid metabolite released during HPV. The results suggest that epidural anesthesia does not inhibit HPV, but exerts some effects on thromboxane B2 synthesis during alveolar hypoxia.
在20例患者中研究了硬膜外麻醉对肺泡低氧期间前列腺素合成的影响。第一组接受静脉麻醉，第二组接受硬膜外和静脉麻醉。两组患者均用双腔气管导管插管，允许右肺用5%二氧化碳、6%氧气和89%氮气进行单独通气作为低氧刺激，左肺用100%氧气通气。两组均维持了足够的全身氧合。两组的肺动脉压和肺血管阻力均显著增加。第二组的心指数显著降低。第一组中6-酮-前列腺素F1α和血栓素B2均增加，但第二组中仅6-酮-前列腺素F1α增加。低氧性肺血管收缩（HPV）刺激前列腺素合成。6-酮-前列腺素F1α是HPV期间释放的主要花生四烯酸代谢产物。结果表明，硬膜外麻醉不抑制HPV，但在肺泡低氧期间对血栓素B2的合成有一定影响。
