Dzhokhadze A D, Managadze L G
Urol Nefrol (Mosk). 1991 Jan-Feb(1):26-8.
Three types of cardiovascular system response were revealed in course of transurethral surgery. In the first 10-20 min after peridural anesthesia there was a decrease in total peripheral vascular resistance in all patients. This provided a positive effect in 84% of them as evidenced by normalized blood pressure, heart rate and cardiac output. In 8% of the operated on, lower total peripheral vascular resistance caused dangerous hypotension due to their weak compensatory mechanisms. 8% had a two-phase blood pressure decrease: firstly its decrease to subnormal levels was associated with lower total peripheral vascular resistance, but a repeated decrease (30-40 min later) in blood pressure to a critical level was initiated by a reduction in cardiac output and depletion of compensatory mechanisms, perhaps, due to a surgical hemorrhage. The both types of hemodynamic destabilization were easily corrected by an alpha-adrenomimetic drug (mezaton) infusions and graded intravenous administration. In case of a proper hemodynamic correction, the peridural anesthesia secured an optimal regime for the function of cardiovascular, respiratory and central nervous systems.
经尿道手术过程中发现了三种类型的心血管系统反应。在硬膜外麻醉后的最初10 - 20分钟内，所有患者的总外周血管阻力均降低。这对84%的患者产生了积极影响，表现为血压、心率和心输出量恢复正常。8%的手术患者由于代偿机制较弱，总外周血管阻力降低导致危险的低血压。8%的患者出现两阶段血压下降：首先血压降至正常以下水平与总外周血管阻力降低有关，但随后（30 - 40分钟后）血压再次下降至临界水平是由心输出量减少和代偿机制耗竭引起的，可能是由于手术出血。这两种类型的血流动力学不稳定通过输注α - 肾上腺素能药物（美速克新命）和分级静脉给药很容易得到纠正。在进行适当的血流动力学纠正后，硬膜外麻醉确保了心血管、呼吸和中枢神经系统功能的最佳状态。
