Jakobson S, Ivarsson I
Acta Anaesthesiol Scand. 1977;21(6):489-96. doi: 10.1111/j.1399-6576.1977.tb01250.x.
Bilateral blockade of the 5th to 11th intercostal nerves, inclusive, was produced in 14 healthy subjects. In seven, bupivacaine 0.25% was used, and in the other seven, etidocaine 0.5%. The latter has been found to have a stronger motor-blocking action than the former. Before and after the blockade, the vital capacity (VC), peak expiratory flow rate (PEF), tidal volumes, respiratory variations in rib cage and abdominal circumferences and in oesophageal and intragastric pressures were recorded. By transthoracic electrical impedance pneumography, measures indicating changes in the functional residual capacity (FRC) were obtained. Although it was considered that changes in the parameters investigated mainly demonstrated changes in motor function, no differences were found between the drugs. With this form of blockade they seem to have equivalent effects in this respect. Thus, VC decreased by an average of 7% and PEF by 6%. Signs of a reduction of FRC after the blockade were also observed. The blockade had no effect on the partitioning of costal and abdominal breathing at rest. Analysis of the relations between the fractions of costal and abdominal breathing and the corresponding variations in intragastric pressure gave support to the view that in normal individuals both intercostal and abdominal muscles remain passive during respiration at rest. This is thus achieved by the diaphragm alone.
对14名健康受试者进行双侧第5至11肋间神经阻滞（包括第5至11肋间神经）。其中7名使用0.25%布比卡因，另外7名使用0.5%依替卡因。已发现后者比前者具有更强的运动阻滞作用。在阻滞前后，记录肺活量（VC）、呼气峰值流速（PEF）、潮气量、胸廓和腹围的呼吸变化以及食管和胃内压力。通过经胸电阻抗肺通气描记法，获得了表明功能残气量（FRC）变化的测量值。尽管认为所研究参数的变化主要表明运动功能的变化，但两种药物之间未发现差异。对于这种形式的阻滞，它们在这方面似乎具有等效作用。因此，VC平均下降7%，PEF下降6%。还观察到阻滞后FRC降低的迹象。该阻滞对静息时肋式呼吸和腹式呼吸的分配没有影响。对肋式呼吸和腹式呼吸的比例与胃内压力相应变化之间关系的分析支持了这样一种观点，即正常个体在静息呼吸时肋间肌和腹肌均保持被动状态。因此，这仅通过膈肌来实现。
