Sekiguchi Y
Masui. 1989 Aug;38(8):1042-7.
Effects of celiac plexus block (CPB) on systemic and splanchnic circulation, especially of liver and kidney, were investigated in twenty nine mongrel dogs. CPB was performed by an anterior approach through a catheter placed in a paraaortic compartment using 7 mg.kg-1 of 2% mepivacaine. Tissue blood flow measurement was performed by a hydrogen clearance method in eleven dogs, and vascular blood flow was measured in eighteen dogs by an electromagnetic flow meter. Swan-Ganz catheter was inserted to measure mean arterial pressure (ABP), heart rate (HR), central venous pressure (CVP), mean pulmonary artery pressure (PAP), pulmonary capillary wedge pressure (PCWP) and cardiac output (CO). Then stroke volume (SV), systemic vascular resistance (SVR) and pulmonary vascular resistance (PVR) were calculated. Following CPB, ABP, HR, CVP and C.O. were significantly decreased at 7 to 9%. PAP decreased at 5%. PCWP, SV, SVR and PVR were unchanged. The hepatic arterial blood flow increased significantly, and portal venous blood flow decreased after CPB transiently, and then recovered to control value or to a higher level at 60min after CPB. The tissue blood flow of the liver tended to increase, but the change was not significant. In the kidney, both arterial and tissue blood flows increased significantly after CPB. The results suggest that following CPB, hepatic and renal tissue blood flows increased because of the increments of their arterial blood flows, unless a profound systemic hemodynamic depression occurred.
在29只杂种犬中研究了腹腔神经丛阻滞(CPB)对全身和内脏循环,特别是肝脏和肾脏循环的影响。通过将导管经前路置于主动脉旁间隙,使用7mg·kg-1的2%甲哌卡因进行CPB。11只犬采用氢清除法测量组织血流量,18只犬用电磁流量计测量血管血流量。插入Swan-Ganz导管以测量平均动脉压(ABP)、心率(HR)、中心静脉压(CVP)、平均肺动脉压(PAP)、肺毛细血管楔压(PCWP)和心输出量(CO)。然后计算每搏输出量(SV)、全身血管阻力(SVR)和肺血管阻力(PVR)。CPB后,ABP、HR、CVP和CO显著降低7%至9%。PAP降低5%。PCWP、SV、SVR和PVR未改变。CPB后肝动脉血流量显著增加,门静脉血流量短暂减少,然后在CPB后60分钟恢复至对照值或更高水平。肝脏组织血流量有增加趋势,但变化不显著。在肾脏,CPB后动脉血流量和组织血流量均显著增加。结果表明,CPB后,除非发生严重的全身血流动力学抑制,肝脏和肾脏组织血流量因动脉血流量增加而增加。