Kim J M, Reed K
Can J Anaesth. 1987 Jul;34(4):358-61. doi: 10.1007/BF03010133.
Following transurethral resection of the prostate under spinal anaesthesia, 26 patients were divided into two groups according to the sensory levels measured in the recovery room: Group A: 20 patients with sensory level T10 or above, and Group B: six patients with sensory level T11 or T12. Through an intravenous catheter placed preoperatively in a superficial vein of the foot, serial blood samples were drawn to measure the PvO2. In Group A, the PvO2 increased significantly after spinal anaesthesia compared with preoperative control values, then decreased when the sensory level receded to T11 or T12. In Group B, the changes in PvO2 from control to postspinal and to motor recovery were not significant. The authors postulate that sympathetic denervation induced by spinal anaesthesia increases the PvO2 by the opening of arteriovenous anastomoses in the cutaneous circulation, and the PvO2 decreases with sympathetic recovery. These findings confirm that significant sympathetic denervation of the lower limbs can be expected at a sensory level of T10 or above, and sympathetic recovery begins when the sensory level recedes below T10.
在脊髓麻醉下经尿道前列腺切除术后，26例患者根据在恢复室测量的感觉平面分为两组：A组：20例感觉平面在T10及以上的患者，B组：6例感觉平面在T11或T12的患者。通过术前置于足部浅表静脉的静脉导管，采集系列血样以测量混合静脉血氧分压（PvO2）。在A组中，与术前对照值相比，脊髓麻醉后PvO2显著升高，当感觉平面降至T11或T12时则降低。在B组中，从对照到脊髓麻醉后以及到运动恢复时PvO2的变化不显著。作者推测，脊髓麻醉引起的交感神经去神经支配通过开放皮肤循环中的动静脉吻合支使PvO2升高，且PvO2随交感神经恢复而降低。这些发现证实，在感觉平面T10及以上时可预期下肢出现明显的交感神经去神经支配，而当感觉平面降至T10以下时交感神经开始恢复。
