Engberg G, Wiklund L
Acta Anaesthesiol Scand Suppl. 1978;66(66):27-36. doi: 10.1111/j.1399-6576.1978.tb01351.x.
The changes in central circulation following a small dose of intravenously administered ephedrine were studied in middle-aged and elderly patients during high epidural blockade with bupivacaine 0.5% with adrenaline, etidocaine 1% with adrenaline, and etidocaine 1% plain. Itravenously injected ephedrine restored the mean, systolic and diastolic arterial blood pressures to the preanalgesic value independent of the degree of hypotension, and was not followed by marked hypertension in any case. Although the heart rate did not change, the cardiostimulatory effects were more pronounced than after subcutaneous premedication, resulting in increased stroke volume and cardiac output in all groups. Peripheral vascular resistance increased to the preanalgesic value in the groups receiving bupivacaine adrenaline and etidocaine plain. In the etidocaine adrenaline group, peripheral vascular resistance was little changed, as the cardiostimulatory effects were more pronounced than in the other groups.
在中年和老年患者中,使用0.5%布比卡因加肾上腺素、1%依替卡因加肾上腺素以及1%单纯依替卡因进行高位硬膜外阻滞时,研究了小剂量静脉注射麻黄碱后中心循环的变化。静脉注射麻黄碱可将平均动脉压、收缩压和舒张压恢复至镇痛前水平,与低血压程度无关,且在任何情况下均未继发明显高血压。虽然心率未发生变化,但心脏刺激作用比皮下给予术前用药后更为明显,导致所有组的每搏输出量和心输出量增加。在接受布比卡因加肾上腺素和单纯依替卡因的组中,外周血管阻力增加至镇痛前水平。在依替卡因加肾上腺素组中,外周血管阻力变化不大,因为心脏刺激作用比其他组更为明显。