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局部神经阻滞下人体对短暂静态收缩的心血管反应。

Cardiovascular responses to brief static contractions in man with topical nervous blockade.

作者信息

Lassen A, Mitchell J H, Reeves D R, Rogers H B, Secher N H

机构信息

Department of Anaesthesia, Rigshospitalet, University of Copenhagen, Denmark.

出版信息

J Physiol. 1989 Feb;409:333-41. doi: 10.1113/jphysiol.1989.sp017500.

Abstract
  1. We tested the hypothesis that afferent nerves from working muscles are important in determining the heart rate and blood pressure responses to brief maximal static exercise. 2. In twenty human subjects, the heart rate and arterial blood pressure responses to a brief maximal voluntary handgrip were studied before and after axillary nerve anaesthesia or to maximal one-leg knee extension before and after epidural anaesthesia at L3-L4. Maximal knee extension could not be accomplished without performing a 'Valsalva-like' manoeuvre, but during handgrip it was possible to avoid the use of muscles other than those directly involved in the contraction. Heart rate and blood pressure were also monitored during a Valsalva manoeuvre of similar duration to the maximal voluntary contractions (4 s). 3. During handgrip with normal breathing, axillary nerve anaesthesia reduced the heart rate response but had no effect on the blood pressure response. 4. During a Valsalva manoeuvre, blood pressure increased but heart rate remained stable as long as expiratory pressure was maintained. During one-leg knee extension, epidural anaesthesia reduced the blood pressure response; however, the reduction in blood pressure was probably due to a reduction in the simultaneously performed 'Valsalva-like' manoeuvre. 5. The results of this study suggest that afferent input from the working muscles is of importance for the heart rate responses to brief static muscle contractions. That such influence may be important for the blood pressure response remains unproven.
摘要
  1. 我们检验了这样一个假设,即来自运动肌肉的传入神经在决定对短暂最大强度静态运动的心率和血压反应中起重要作用。2. 在20名人类受试者中,研究了在腋神经麻醉前后对短暂最大强度自愿握力的心率和动脉血压反应,以及在L3-L4硬膜外麻醉前后对最大强度单腿膝关节伸展的心率和动脉血压反应。不进行“瓦氏动作样”操作就无法完成最大强度膝关节伸展,但在握力过程中可以避免使用除直接参与收缩的肌肉以外的其他肌肉。在与最大强度自愿收缩持续时间相似(4秒)的瓦氏动作过程中也监测了心率和血压。3. 在正常呼吸下握力时,腋神经麻醉降低了心率反应,但对血压反应没有影响。4. 在瓦氏动作过程中,只要保持呼气压力,血压就会升高,但心率保持稳定。在单腿膝关节伸展过程中,硬膜外麻醉降低了血压反应;然而,血压降低可能是由于同时进行的“瓦氏动作样”操作减少所致。5. 本研究结果表明,来自运动肌肉的传入输入对短暂静态肌肉收缩的心率反应很重要。这种影响对血压反应是否重要仍未得到证实。

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