Kochi T, Sako S, Nishino T, Mizuguchi T
Department of Anaesthesiology, Chiba University School of Medicine, Japan.
Br J Anaesth. 1989 Apr;62(4):362-7. doi: 10.1093/bja/62.4.362.
We have investigated, in six healthy male volunteers, the effect of high thoracic extradural anaesthesia on the ventilatory pattern and hypercapnic ventilatory response. Ventilatory variables were determined using a respiratory inductive plethysmograph. Duration of inspiration, rib cage excursion and its contribution to tidal volume decreased significantly following extradural anaesthesia, while mean inspiratory flow rate and minute ventilation increased. End-tidal PCO2 and the tidal excursion of the abdomen were unchanged. Hypercapnic ventilatory response decreased significantly following extradural anaesthesia, principally because of the rib cage component. The slope of the abdominal component did not change significantly. The results indicate that mechanical impairment of rib cage movement can produce decreased ventilatory response to carbon dioxide. The ventilatory impairment and the changes in breathing pattern induced by the high thoracic extradural anaesthesia probably reflect blockade of the efferent or afferent pathway (or both) of the intercostal nerve roots.
我们在六名健康男性志愿者身上研究了高位胸段硬膜外麻醉对通气模式和高碳酸通气反应的影响。使用呼吸感应体积描记法测定通气变量。硬膜外麻醉后，吸气持续时间、胸廓运动幅度及其对潮气量的贡献显著降低，而平均吸气流量和分钟通气量增加。呼气末二氧化碳分压和腹部潮气量未改变。硬膜外麻醉后高碳酸通气反应显著降低，主要是由于胸廓部分。腹部部分的斜率没有显著变化。结果表明，胸廓运动的机械性损害可导致对二氧化碳的通气反应降低。高位胸段硬膜外麻醉引起的通气损害和呼吸模式改变可能反映了肋间神经根传出或传入通路（或两者）的阻滞。
