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体外循环期间的周期性血压变化——颈胸段硬膜外麻醉和酚妥拉明的影响

[Periodical blood pressure variation during cardiopulmonary bypass--effects of cervicothoracic epidural anesthesia and phentolamine].

作者信息

Sasano H, Sasano N, Ishida S, Oda N, Miura M, Baba E, Yamada M, Moriya T, Takamiya T, Hayano J

机构信息

Department of Anesthesia, Gifu Prefectural Tajimi Hospital, Tajimi.

出版信息

Masui. 1994 Oct;43(10):1454-60.

PMID:7815693
Abstract

We studied the effects of cervicothoracic epidural anesthesia or intravenous phentolamine on periodical blood pressure variation during cardiopulmonary bypass in 12 adult patients undergoing open heart surgery under fentanyl anesthesia. Spontaneous periodical fluctuation of the blood pressure was analyzed by means of autoregressive power spectrum method. Amplitudes of the low frequency (0.02-0.15 Hz) component of the blood pressure variation amplitudes were calculated. The amplitudes decreased significantly 10 minutes after cervicothoracic epidural block with 15 ml of 2% lidocaine solution (P < 0.05), and after infusion of 0.4 mg.kg-1 of phentolamine (P < 0.05). Since amplitudes of the blood pressure variation were reduced by adequate epidural block or phentolamine, they are likely to reflect sympathetic vasomotor activity.

摘要

我们研究了颈胸段硬膜外麻醉或静脉注射酚妥拉明对12例在芬太尼麻醉下接受心脏直视手术的成年患者体外循环期间血压周期性变化的影响。采用自回归功率谱法分析血压的自发性周期性波动。计算血压变化幅度的低频(0.02 - 0.15Hz)成分的幅度。在注入15ml 2%利多卡因溶液进行颈胸段硬膜外阻滞10分钟后(P < 0.05)以及注入0.4mg·kg⁻¹酚妥拉明后(P < 0.05),幅度显著降低。由于适当的硬膜外阻滞或酚妥拉明可降低血压变化幅度,它们可能反映交感神经血管运动活性。

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