Shibata K, Yamamoto Y, Murakami S
Department of Anesthesiology, School of Medicine, Kanazawa University, Japan.
Anesthesiology. 1989 Dec;71(6):953-9. doi: 10.1097/00000542-198912000-00020.
The purpose of the present study was to assess the effects of epidural anesthesia on cardiovascular responses and survival in experimental hemorrhagic shock in dogs. Thirty mongrel dogs were randomly assigned to one of three groups on the basis of anesthetic technique: the upper-level group (n = 10), receiving general anesthesia plus upper-level (mainly thoracic region) epidural anesthesia; the lower-level group (n = 10), receiving general anesthesia plus lower-level (mainly lumbar region) epidural anesthesia; and the control group (n = 10), receiving general anesthesia alone. After withdrawal of blood, the changes in mean arterial pressure (40 mmHg) and cardiac index were similar in all groups. In the upper-level group, a lower heart rate and systemic vascular resistance than the control group were maintained throughout in the presence of severe hypotension. A significant difference in survival was seen between the upper-level and control groups over the 100-min observation period as a whole (P less than 0.05 by the Generalized Wilcoxon test), since, at the end of the period, only two of the ten animals in the control group survived, whereas nine of ten in the upper-level group survived (P less than 0.001 by the Kaplan-Meier test). This result demonstrates that, in dogs lightly anesthetized with halothane and nitrous oxide, upper thoracic level epidural anesthesia significantly improves survival in experimental hemorrhagic shock (compared with survival in dogs with lumbar epidural or no epidural anesthesia) when the epidural is performed before hemorrhage and when the mean arterial pressure is constant.(ABSTRACT TRUNCATED AT 250 WORDS)
本研究的目的是评估硬膜外麻醉对犬实验性失血性休克时心血管反应及存活情况的影响。根据麻醉技术，将30只杂种犬随机分为三组：高位组（n = 10），接受全身麻醉加高位（主要为胸部区域）硬膜外麻醉；低位组（n = 10），接受全身麻醉加低位（主要为腰部区域）硬膜外麻醉；对照组（n = 10），仅接受全身麻醉。放血后，所有组的平均动脉压（40 mmHg）和心脏指数变化相似。在高位组，在严重低血压情况下，整个过程中心率和全身血管阻力均低于对照组。在整个100分钟观察期内，高位组和对照组的存活情况存在显著差异（广义威尔科克森检验，P < 0.05），因为在观察期末，对照组10只动物中仅2只存活，而高位组10只中有9只存活（卡普兰 - 迈耶检验，P < 0.001）。这一结果表明，在使用氟烷和氧化亚氮轻度麻醉的犬中，当在出血前进行硬膜外麻醉且平均动脉压恒定时，胸段高位硬膜外麻醉可显著提高实验性失血性休克的存活率（与腰部硬膜外麻醉或无硬膜外麻醉的犬相比）。（摘要截短于250字）
