Lennon R L, Linstromberg J W
Anesth Analg. 1983 Feb;62(2):215-7.
Large volumes of an anesthetic solution used during regional axillary anesthesia may produce elevated pressures within the axillary sheath that lead to arterial compression and diminished blood flow. We measured axillary sheath pressure as a function of injected volume in 20 patients scheduled for hand surgery. Bupivacaine without epinephrine was injected into the axillary sheath in 10-ml increments until a cumulative volume of 50 ml was attained. Elastance (delta P/delta V), where delta P equals change in pressure (mm Hg) and delta V equals change in volume (ml), was 0.8 +/- 0.1 (+/- SEM) mm Hg/ml in successful block and 0.09 +/- 0.1 mm Hg/ml in unsuccessful blocks. Axillary sheath pressure did not exceed mean arterial pressure for periods longer than 60 s. We conclude that vascular insufficiency resulting from arterial compression following axillary block anesthesia is unlikely.
在腋路区域麻醉期间使用大量麻醉溶液可能会导致腋鞘内压力升高，进而引起动脉受压和血流减少。我们对20例计划进行手部手术的患者测量了腋鞘压力与注射容量的关系。将不含肾上腺素的布比卡因以10毫升的增量注入腋鞘，直至累积容量达到50毫升。弹性（ΔP/ΔV），其中ΔP等于压力变化（毫米汞柱），ΔV等于容量变化（毫升），在成功阻滞时为0.8±0.1（±标准误）毫米汞柱/毫升，在未成功阻滞时为0.09±0.1毫米汞柱/毫升。腋鞘压力超过平均动脉压的时间不超过60秒。我们得出结论，腋路阻滞麻醉后因动脉受压导致血管功能不全的可能性不大。
