Reiz S, Nath S, Pontén E, Friedman A, Bäcklund U, Olsson B, Rais O
Acta Anaesthesiol Scand. 1979 Oct;23(5):395-403. doi: 10.1111/j.1399-6576.1979.tb01466.x.
Sixteen patients scheduled for abdominal aortic resection and grafting were randomly assigned to two groups to study the cardiovascular effects of infrarenal aortic cross-clamping. The patients in the first group had received a thoracic epidural block followed by intravenous administration of the selective beta-1-adrenoreceptor agonist prenalterol prior to induction of general anaesthesia. The patients in the second group served as controls and received no specific treatment prior to general anaesthesia. In both groups, aortic cross-clamping was followed by an equal rise in pulmonary artery diastolic pressure and mean systemic arterial pressure. There was a significant difference in systemic vascular resistance, as the control group had a 46% increase 30 s after cross-clamping, while the pretreated patients had only a 7% increase at the same time. Moreover, the patients given the thoracic epidural block followed by prenalterol increased their stroke volume and cardiac indices, as compared to the patients in the control group who showed a significant decrease in these parameters. Possible mechanisms for the mode of action of the combined thoracic epidural block and beta-1-adrenoreceptor agonist pretreatment are discussed.
16例计划行腹主动脉切除及血管移植术的患者被随机分为两组，以研究肾下主动脉阻断对心血管系统的影响。第一组患者在全身麻醉诱导前接受了胸段硬膜外阻滞，随后静脉注射选择性β1肾上腺素能受体激动剂普瑞特罗。第二组患者作为对照组，在全身麻醉前未接受特殊治疗。两组患者在主动脉阻断后肺动脉舒张压和平均体动脉压均有相同程度的升高。全身血管阻力存在显著差异，因为对照组在阻断后30秒增加了46%，而预处理组患者在同一时间仅增加了7%。此外，与对照组患者这些参数显著降低相比，接受胸段硬膜外阻滞并注射普瑞特罗的患者每搏输出量和心脏指数增加。文中讨论了胸段硬膜外阻滞联合β1肾上腺素能受体激动剂预处理作用模式的可能机制。
