Shiroyama K, Nakagawa I, Izumi H, Kurokawa H, Kuroda M
Department of Anesthesia, Chugoku Rousai General Hospital, Kure.
Masui. 1994 May;43(5):697-701.
A retrospective study was conducted on the cause of hypotension during spinal anesthesia and also on the relation between the level of anesthesia and the hypotension. Two hundred twenty three patients who had received spinal anesthesia for gynecological surgery were divided into two groups. Group I consisted of 87 patients with a significant decrease in blood pressure, while group II consisted of 136 patients with no significant decrease in blood pressure. First, the age, dosage of spinal anesthesia, amount of preoperative transfusion, and level of spinal anesthesia were reviewed and compared between the group I and II. Next, all the patients were classified by the level of spinal anesthesia, and the degree of decrease in blood pressure and the frequency of a significant decrease in blood pressure were examined by each level of spinal anesthesia. Only the level of spinal anesthesia was found to differ significantly between the group I and II. The degree of hypotension was greater at higher levels of spinal anesthesia. More than 50% of the patients with T5 or higher levels of anesthesia had a significant decrease in blood pressure. We conclude that the cause of the significant decrease in blood pressure during high spinal anesthesia is in most part due to the blockade of the cardiac sympathetic nerve.
对脊髓麻醉期间低血压的原因以及麻醉平面与低血压之间的关系进行了一项回顾性研究。223例接受脊髓麻醉进行妇科手术的患者被分为两组。第一组由87例血压显著下降的患者组成，而第二组由136例血压无显著下降的患者组成。首先，对第一组和第二组患者的年龄、脊髓麻醉剂量、术前输血量以及脊髓麻醉平面进行回顾和比较。接下来，根据脊髓麻醉平面将所有患者进行分类，并检查每个脊髓麻醉平面的血压下降程度和血压显著下降的频率。结果发现，仅第一组和第二组之间的脊髓麻醉平面存在显著差异。脊髓麻醉平面越高，低血压程度越严重。麻醉平面在T5或更高水平的患者中，超过50%出现了血压显著下降。我们得出结论，高位脊髓麻醉期间血压显著下降的原因在很大程度上是由于心脏交感神经被阻断。
