Davis F M, Laurenson V G, Gillespie W J, Foate J, Seagar A D
Division of Anaesthesia, Christchurch Clinical School of Medicine, University of Otago, New Zealand.
Anaesth Intensive Care. 1989 May;17(2):136-43. doi: 10.1177/0310057X8901700203.
Calf blood flow was studied using venous occlusion impedance plethysmography during 122 total hip arthroplasties. Patients were randomly allocated to receive spinal or general anaesthesia. Blood flow was measured nine times perioperatively. In the non-surgical leg, mean blood flow rose by over 50% in both groups following anaesthetic induction, remaining significantly elevated with spinal but falling back gradually to baseline with general anaesthesia. In the surgical leg, surgical manipulations produced marked falls in flow in many patients, particularly with femoral component insertion. If this occurred, hyperaemia was commonly seen with spinal anaesthesia but rarely with general anaesthesia once the joint was relocated. Venous outflow resistance rose slightly during anaesthesia in both groups, more so with general anaesthesia. In the surgical leg, marked rises occurred with surgical manipulations, but resistance fell abruptly once the joint was relocated. No clear relationship between these observations and the occurrence of deep vein thrombosis postoperatively was established.
在122例全髋关节置换术中，使用静脉阻塞阻抗体积描记法研究了小腿血流量。患者被随机分配接受脊髓麻醉或全身麻醉。围手术期测量血流量9次。在非手术侧下肢，两组患者在麻醉诱导后平均血流量均增加超过50%，脊髓麻醉组仍显著升高，而全身麻醉组则逐渐回落至基线水平。在手术侧下肢，手术操作使许多患者的血流量显著下降，尤其是在插入股骨假体时。如果出现这种情况，脊髓麻醉时常见充血，而一旦关节复位，全身麻醉时很少出现充血。两组在麻醉期间静脉流出阻力均略有上升，全身麻醉时更为明显。在手术侧下肢，手术操作时阻力显著上升，但一旦关节复位，阻力会突然下降。这些观察结果与术后深静脉血栓形成的发生之间未建立明确的关系。
