Greitz T, Andreen M, Irestedt L
Acta Anaesthesiol Scand. 1984 Oct;28(5):557-62. doi: 10.1111/j.1399-6576.1984.tb02119.x.
High lumbar epidural block was induced in seven dogs with 0.5% bupivacaine, causing a fall in mean arterial blood pressure (AP) from 19.2 +/- 3.2 to 10.5 +/- 3.2 kPa, owing to equal reductions in cardiac output (QT) and systemic vascular resistance (SVR). After the administration of ephedrine (a single injection of 200-300 micrograms X kg-1 b.w. followed by a continuous infusion of 10-20 micrograms X kg-1 b.w. X min-1) AP, QT and SVR rose to pre-epidural values. Furthermore, the hypokinetic circulation following the epidural block returned to normokinetic levels. Portal venous blood flow was increased from 16.5 +/- 6.2 to 25.5 +/- 4.3 ml X kg-1 b.w. X min-1 by ephedrine, while the hepatic arterial blood flow was unchanged and remained at its pre-epidural level. In spite of a slight rise in hepatic oxygen consumption from 1.2 +/- 0.4 to 1.6 +/- 0.6 ml X kg-1 b.w. X min-1, the percentages of oxygen extracted from the portal vein and the hepatic artery decreased significantly. It is concluded that ephedrine restores central and splanchnic haemodynamics in a desirable manner during high epidural anaesthesia.
对7只犬进行高位腰段硬膜外阻滞,使用0.5%布比卡因,导致平均动脉血压(AP)从19.2±3.2kPa降至10.5±3.2kPa,这是由于心输出量(QT)和全身血管阻力(SVR)同等程度降低所致。给予麻黄碱后(单次注射200 - 300微克/千克体重,随后以10 - 20微克/千克体重·分钟-1持续输注),AP、QT和SVR升至硬膜外阻滞前水平。此外,硬膜外阻滞后的低动力循环恢复到正常动力水平。麻黄碱使门静脉血流量从16.5±6.2毫升/千克体重·分钟-1增加至25.5±4.3毫升/千克体重·分钟-1,而肝动脉血流量未变,维持在硬膜外阻滞前水平。尽管肝脏氧耗量略有增加,从1.2±0.4毫升/千克体重·分钟-1升至1.6±0.6毫升/千克体重·分钟-1,但从门静脉和肝动脉摄取的氧百分比显著下降。结论是,在高位硬膜外麻醉期间,麻黄碱能以理想方式恢复中枢和内脏血流动力学。