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人体硬膜外麻醉期间对动态运动的心血管和通气反应。

Cardiovascular and ventilatory responses to dynamic exercise during epidural anaesthesia in man.

作者信息

Fernandes A, Galbo H, Kjaer M, Mitchell J H, Secher N H, Thomas S N

机构信息

Department of Anaesthesia Rigshospitalet, Copenhagen, Denmark.

出版信息

J Physiol. 1990 Jan;420:281-93. doi: 10.1113/jphysiol.1990.sp017912.

Abstract
  1. In order to evaluate the importance of afferent neural feedback from the working muscles for cardiovascular and ventilatory responses to dynamic exercise, epidural anaesthesia was induced at L3-L4. Six healthy males cycled for 20 min at 57% of maximum oxygen uptake and for 8-12 min at increasing work intensities until exhaustion at 238 +/- 30 W without as well as with epidural anaesthesia. 2. Presence of afferent neural blockade was verified by cutaneous sensory analgesia below T10-T11 and attenuated post-exercise ischaemic pressor response (45 +/- 8-24 +/- 6 mmHg). Efferent sympathetic nerves appear to be intact since basal heart rate and blood pressure as well as the cardiovascular responses to a Valsalva manoeuvre and to a cold pressor test were unchanged. 3. During dynamic exercise with epidural anaesthesia, blood pressure was lower than in control experiments; however, ventilation and heart rate were not affected. 4. The results indicate that afferent neural activity from the working muscles is important for blood pressure regulation during dynamic exercise in man but may not be necessary for eliciting the ventilatory and heart rate responses.
摘要
  1. 为了评估来自工作肌肉的传入神经反馈对动态运动时心血管和通气反应的重要性,在L3 - L4水平诱导硬膜外麻醉。六名健康男性在最大摄氧量的57%下骑行20分钟,并在不断增加的工作强度下骑行8 - 12分钟,直至在238±30瓦时疲劳,实验过程中有无硬膜外麻醉两种情况均进行了测试。2. 通过T10 - T11以下皮肤感觉镇痛以及运动后缺血性升压反应减弱(45±8 - 24±6 mmHg)来证实存在传入神经阻滞。传出交感神经似乎完好无损,因为基础心率和血压以及对瓦尔萨尔瓦动作和冷加压试验的心血管反应均未改变。3. 在硬膜外麻醉下进行动态运动时,血压低于对照实验;然而,通气和心率未受影响。4. 结果表明,来自工作肌肉的传入神经活动对人体动态运动时的血压调节很重要,但引发通气和心率反应可能并非必需。

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