Helms U, Weihrauch H
Prakt Anaesth. 1979 Feb;14(1):23-35.
In 22 elderly patients haemodynamic alterations after epidural anaesthesia with Carticain 2% (Ultracain) with epinephrine (1:200 000) were compared to those after Lidocaine 2% with epinephrine. There were no differences to be found in these agents, and a less pronounced depressing effect of Carticain on circulation could not be confirmed. Unlike young people elderly patients only develop slight and short rises of heart rate and cardiac output after epidural anaesthesia, which are not sufficient to compensate for the distinct fall of mean arterial pressure up to the 15th minute. In our study mean arterial pressure decreased to critical values which might lead to cerebral and coronary ischemia in these patients. Adequate prophylactic and therapeutic measures are discussed.
对22例老年患者，比较了使用含肾上腺素（1:200 000）的2%卡替卡因（优卡因）硬膜外麻醉与使用含肾上腺素的2%利多卡因硬膜外麻醉后的血流动力学改变。未发现这两种药物有差异，且未证实卡替卡因对循环的抑制作用较轻。与年轻人不同，老年患者硬膜外麻醉后仅出现轻微且短暂的心率和心输出量升高，不足以补偿直至第15分钟时平均动脉压的明显下降。在我们的研究中，平均动脉压降至临界值，这可能导致这些患者出现脑和冠状动脉缺血。文中讨论了适当的预防和治疗措施。
