Shamaev E M, Kosonogov L F
Anesteziol Reanimatol. 1991 Nov-Dec(6):52-5.
Central and pulmonary hemodynamic parameters have been studied by total body and transthoracic plethysmography in 60 patients before surgery, after surgery and on the 2nd, 4th and 9th day of the postoperative period. Neuroleptanalgesia and postoperative intramuscular analgesia with analgesics have been performed to control patients. Test patients during surgery and for 18 hours postoperatively have been subjected to upper thoracic epidural anesthesia with trimecaine and morphine. Marked stress hemodynamic reaction in control patients right after surgery and its following gradual inhibition with signs of right ventricular overload corresponded to a complicated clinical course. Reduced right ventricular afterload in test patients, minimum changes in right-ventricular performance and inotropic properties in combination with uncomplicated clinical course make it possible to consider the use of prolonged epidural anesthesia justified in thoracic cancer surgery.
通过全身和经胸体积描记法对60例患者术前、术后以及术后第2天、第4天和第9天的中心和肺血流动力学参数进行了研究。采用神经安定镇痛术和术后肌肉注射镇痛药来控制患者。手术期间及术后18小时,试验组患者接受了三甲卡因和吗啡的上胸段硬膜外麻醉。对照组患者术后立即出现明显的应激血流动力学反应,随后逐渐受到抑制并伴有右心室负荷过重的体征,这与复杂的临床病程相对应。试验组患者右心室后负荷降低,右心室功能和变力特性变化最小,且临床病程不复杂,这使得在胸段癌手术中使用延长硬膜外麻醉成为可能。