Arakawa M, Goto F
Department of Anesthesiology, Kitasato University School of Medicine, Kanagawa, Japan.
Can J Anaesth. 1994 Aug;41(8):680-7. doi: 10.1007/BF03015621.
The purpose of this study was to evaluate autonomic nervous system activity during high and low lumbar epidural anaesthesia. Ten patients undergoing lower limb surgery with lumbar epidural anaesthesia (low epidural anaesthesia group; mean upper dermal block level, T10.7 +/- 1.1), and ten patients undergoing either abdominal total hysterectomy or inguinal hernia under lumbar epidural anaesthesia (high epidural anaesthesia group; mean upper dermal block level, T5.1 +/- 1.0). Ten healthy volunteers were used as the control group. The autonomic nervous system activity was measured by heart rate and blood pressure variability with power spectral analysis. For the analysis of heart rate variability, frequency components were divided into two factors, a low frequency component RR (LFCRR: 0.03 Hz-0.15 Hz) that mediated sympathetic and parasympathetic activity and a high frequency component RR (HFCRR: 0.15 Hz-0.4 Hz) that mediated parasympathetic activity. In the analysis of blood pressure variability, the frequency components were also divided into two factors; a low frequency component of systolic blood pressure and diastolic blood pressure (LFCSBP and LFCDBP: 0.03 Hz-0.15 Hz) that was mediated by peripheral sympathetic vasomotor activity and a higher frequency component of systolic blood pressure and diastolic blood pressure (HFCSBP and HFCDBP: 0.15 Hz-0.4 Hz) that was mediated by a mechanical consequence of respiration. There were no changes in heart rate variability during epidural anaesthesia. However, LFCSBP and LFCDBP decreased in high epidural anaesthesia (P < 0.01). On the contrary, LFCSBP increased in low epidural anaesthesia (P < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)
本研究的目的是评估高位和低位腰椎硬膜外麻醉期间的自主神经系统活动。10例接受下肢手术并采用腰椎硬膜外麻醉的患者（低位硬膜外麻醉组；平均皮节阻滞平面，T10.7±1.1），以及10例接受腹部全子宫切除术或腹股沟疝修补术并采用腰椎硬膜外麻醉的患者（高位硬膜外麻醉组；平均皮节阻滞平面，T5.1±1.0）。10名健康志愿者作为对照组。通过功率谱分析测量心率和血压变异性来评估自主神经系统活动。对于心率变异性分析，频率成分分为两个因素，介导交感神经和副交感神经活动的低频成分RR（LFCRR：0.03Hz - 0.15Hz）和介导副交感神经活动的高频成分RR（HFCRR：0.15Hz - 0.4Hz）。在血压变异性分析中，频率成分也分为两个因素；由外周交感神经血管运动活动介导的收缩压和舒张压的低频成分（LFCSBP和LFCDBP：0.03Hz - 0.15Hz）以及由呼吸机械效应介导的收缩压和舒张压的高频成分（HFCSBP和HFCDBP：0.15Hz - 0.4Hz）。硬膜外麻醉期间心率变异性无变化。然而，高位硬膜外麻醉时LFCSBP和LFCDBP降低（P < 0.01）。相反，低位硬膜外麻醉时LFCSBP升高（P < 0.01）。（摘要截短于250字）
