Abou-Madi M N, Trop D, Barnes J
Can Anaesth Soc J. 1980 Sep;27(5):491-5. doi: 10.1007/BF03007050.
Two groups of 12 patients were studied to determine the causes of hypertension during trans-sphenoidal resection of pituitary microadenomas. Two concentrations of lidocaine, 0.5 and 1.0 per cent with epinephrine 1/200,000, were used to infiltrate the nose and upper gingiva. Heart rate, electrocardiogram lead II and systolic and diastolic arterial blood pressures were monitored. Three stages were observed for changes in above parameters: nasal infiltration, nasal dissection and sellar exploration. Highly significant reductions in arterial blood pressure and pulse rate responses to infiltration and nasal dissection were achieved by increasing the lidocaine concentration used for infiltration from 0.5 to 1.0 per cent (p < 0.05). Our findings implicate reflex from nasal stimulation as the main cause of the adverse cardiovascular effects. Only minimal changes accompanied the progress of the intrasellar dissection in both groups.
对两组各12例患者进行了研究，以确定垂体微腺瘤经蝶窦切除术期间高血压的原因。使用两种浓度的利多卡因（0.5%和1.0%）加1/200,000肾上腺素对鼻腔和上牙龈进行浸润。监测心率、心电图II导联以及动脉收缩压和舒张压。观察到上述参数在三个阶段发生变化：鼻腔浸润、鼻腔解剖和蝶鞍探查。通过将浸润用利多卡因浓度从0.5%提高到1.0%，动脉血压和脉搏率对浸润和鼻腔解剖的反应显著降低（p < 0.05）。我们的研究结果表明，鼻腔刺激反射是心血管不良反应的主要原因。两组在蝶鞍内解剖过程中均仅有微小变化。
