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在高位硬膜外阻滞期间,心得舒和右旋糖酐扩容对犬血流动力学及氧耗的影响,特别关注内脏区域。

Effects of prenalterol and volume loading with dextran on haemodynamics and oxygen consumption in dogs during high epidural block with special reference to the splanchnic region.

作者信息

Greitz T, Andreen M, Irestedt L

出版信息

Acta Anaesthesiol Scand. 1985 Jan;29(1):37-44. doi: 10.1111/j.1399-6576.1985.tb02156.x.

DOI:10.1111/j.1399-6576.1985.tb02156.x
PMID:2579516
Abstract

High lumbar epidural block was induced in seven dogs, causing a fall in mean arterial blood pressure (AP) from 24.5 +/- 2.9 to 12.0 +/- 3.1 kPa owing to reductions in cardiac output (QT) and systemic vascular resistance (SVR) to 67% and 68% of the pre-epidural values. Volume loading with dextran 10 ml X kg-1 b.w. increased QT nearly to the pre-epidural value. SVR decreased further to 61% of the pre-epidural value and AP was only slightly increased to 14.9 +/- 2.7 kPa. Subsequent administration of prenalterol 20 micrograms X kg-1 b.w. caused a further increase in QT to 17% above the pre-epidural value due to an increase in heart rate of 51 beats/min. AP did not change since SVR decreased further to 49% of the pre-epidural value. The hepatic arterial blood flow (QHA) was essentially unchanged during epidural block as well as during volume loading, while the portal venous blood flow (Qpv) was changed concurrently with (QT). In spite of the decrease in SVR, the preportal and hepatic arterial vascular resistances were not diminished following prenalterol. The increase in OT must therefore have favoured other vascular beds. Hepatic and pre-portal tissue oxygen uptakes were unchanged during the experimental procedure, while whole-body oxygen uptake decreased by 20% following the epidural block and increased nearly to the pre-epidural level following volume loading in combination with prenalterol.

摘要

对7只犬进行高位腰段硬膜外阻滞,由于心输出量(QT)和全身血管阻力(SVR)分别降至硬膜外阻滞前值的67%和68%,平均动脉血压(AP)从24.5±2.9kPa降至12.0±3.1kPa。静脉输注10ml/kg体重的右旋糖酐进行容量负荷,QT几乎增加至硬膜外阻滞前值。SVR进一步降至硬膜外阻滞前值的61%,AP仅轻微升至14.9±2.7kPa。随后静脉注射20μg/kg体重的普瑞特罗,由于心率增加51次/分钟,QT进一步增加至硬膜外阻滞前值以上17%。由于SVR进一步降至硬膜外阻滞前值的49%,AP未发生变化。在硬膜外阻滞期间以及容量负荷期间,肝动脉血流量(QHA)基本未变,而门静脉血流量(Qpv)与(QT)同时发生变化。尽管SVR降低,但普瑞特罗给药后门静脉前和肝动脉血管阻力并未降低。因此,QT的增加必定有利于其他血管床。在实验过程中,肝脏和门静脉前组织的氧摄取未变,而硬膜外阻滞后全身氧摄取减少20%,在容量负荷联合普瑞特罗后几乎增加至硬膜外阻滞前水平。

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