Blomberg S, Ricksten S E
Department of Anaesthesia and Intensive Care, Sahlgrens Hospital, Sweden.
Acta Anaesthesiol Scand. 1988 Apr;32(3):166-72. doi: 10.1111/j.1399-6576.1988.tb02709.x.
A simple technique for cannulation of the thoracic epidural space in rats was described. 40-50 microliter of epidural bupivacaine 5 mg/ml induced a distribution of sensory analgesia from lower cervical to lower thoracic segments. With this model, effects of thoracic epidural anaesthesia (TEA) on mean arterial pressure (MAP), cardiac output (CO), systemic vascular resistance (SVR), stroke volume (SV), heart rate (HR), central venous pressure (CVP), left ventricular end-diastolic pressure (LVEDP) and maximal increase of pressure in the left ventricle (max dp/dt) were studied in six groups of animals: 1) In conscious animals (n = 10) MAP, CO, SV and HR decreased significantly by 12%, 25%, 10% and 16%, respectively, while SVR increased significantly by 20% during TEA; 2) In chloralose-anaesthetized animals (n = 7) the reduction in CO during TEA was less pronounced and there were no significant changes in SV or SVR; 3) In conscious animals (n = 6) LVEDP, CVP and max dp/dt decreased significantly during TEA; 4) Hexamethonium, when administered to pharmacologically vagotomized conscious animals during TEA (n = 8), induced a significant decrease in SVR (23%) but no change in HR; 5) Changes in haemodynamics after cardiac adrenoceptor blockade with metoprolol, in conscious animals (n = 12), did not differ significantly from those seen during TEA, except for an unchanged SV after metoprolol; 6) 50 microliters of bupivacaine (5 mg/ml) when given i.v. to conscious animals (n = 8) did not affect CO, SV, HR or TPR significantly, while MAP increased slightly but significantly. Thus, in this conscious animal model, TEA almost completely and rather selectively blocked probably mediated by a reflex activation of unblocked sympathetic efferents.(ABSTRACT TRUNCATED AT 250 WORDS)
本文描述了一种简单的大鼠胸段硬膜外腔置管技术。40 - 50微升浓度为5毫克/毫升的布比卡因硬膜外给药可诱导产生从下颈部到下胸部节段的感觉性镇痛分布。利用该模型,在六组动物中研究了胸段硬膜外麻醉(TEA)对平均动脉压(MAP)、心输出量(CO)、全身血管阻力(SVR)、每搏输出量(SV)、心率(HR)、中心静脉压(CVP)、左心室舒张末期压力(LVEDP)以及左心室压力最大上升速率(max dp/dt)的影响:1)清醒动物(n = 10)在TEA期间,MAP、CO、SV和HR分别显著下降12%、25%、10%和16%,而SVR显著增加20%;2)水合氯醛麻醉的动物(n = 7)在TEA期间CO的降低不太明显,SV或SVR无显著变化;3)清醒动物(n = 6)在TEA期间LVEDP、CVP和max dp/dt显著下降;4)六甲铵在TEA期间给予药理学切断迷走神经的清醒动物(n = 8),可使SVR显著降低(23%),但HR无变化;5)美托洛尔对清醒动物(n = 12)进行心脏肾上腺素能受体阻断后血流动力学的变化与TEA期间所见变化无显著差异,只是美托洛尔给药后SV无变化;6)50微升布比卡因(5毫克/毫升)静脉注射给清醒动物(n = 8)时,对CO、SV、HR或总外周阻力(TPR)无显著影响,而MAP略有但显著升高。因此,在这种清醒动物模型中,TEA几乎完全且相当有选择性地阻断了可能由未阻断的交感传出神经反射激活介导的反应。(摘要截短至250字)