Shibata K, Taki Y, Futagami A, Yamamoto K, Kobayashi T, Murakami S
Department of Anesthesiology and Intensive Care Medicine, School of Medicine, Kanazawa University.
Masui. 1991 Dec;40(12):1777-82.
The purpose of the present study is to assess the influence of upper thoracic epidural anesthesia (TEA) on hemodynamics, the systemic oxygen supply-demand relationship, and several indications of stress in the presence of preexisting hypovolemia. Sixteen adult mongrel dogs were anesthetized with halothane and nitrous oxide, and blood was withdrawn at the rate of 3 ml.kg-1.min-1 for 10 min. The dogs were randomly assigned to two groups; one receiving TEA (TEA group, n = 8), and the other without (controls, n = 8). Mean arterial blood pressure, heart rate, arterial concentrations of epinephrine and norepinephrine remained significantly lower (P less than 0.05) in the TEA group than in the controls during the 100-min observation period following the start of TEA. Cardiac index, oxygen supply-demand ratio (O2 delivery/O2 consumption) and arterial lactate concentration showed no significant intergroup differences at any point during observation. By contrast, there was a significant difference in arterial pH between the TEA group (7.22 +/- 0.05, mean +/- SD) and the controls (7.15 +/- 0.08) after 100 min of TEA. These results indicate that in hypovolemic dogs anesthetized with halothane and nitrous oxide, TEA affects the acid-base balance favorably without significantly influencing the systemic oxygen supply-demand relationship.
本研究的目的是评估在已有血容量不足的情况下，上胸段硬膜外麻醉（TEA）对血流动力学、全身氧供需关系以及应激的若干指标的影响。16只成年杂种犬用氟烷和氧化亚氮麻醉，以3 ml·kg-1·min-1的速率采血10分钟。将犬随机分为两组；一组接受TEA（TEA组，n = 8），另一组不接受（对照组，n = 8）。在开始TEA后的100分钟观察期内，TEA组的平均动脉血压、心率、肾上腺素和去甲肾上腺素的动脉浓度仍显著低于对照组（P < 0.05）。观察期间的任何时间点，心脏指数、氧供需比（氧输送/氧消耗）和动脉乳酸浓度在组间均无显著差异。相比之下，TEA 100分钟后，TEA组（7.22±0.05，均值±标准差）与对照组（7.15±0.08）的动脉pH存在显著差异。这些结果表明，在用氟烷和氧化亚氮麻醉的血容量不足犬中，TEA可有利地影响酸碱平衡，而对全身氧供需关系无显著影响。
