Arakawa M, Amemiya N, Nagai K, Kato S, Goto F
Department of Anesthesiology, Kitasato University, School of Medicine, Kanagawa.
Masui. 1993 Oct;42(10):1464-9.
The aim of the present study was to investigate the effect of epidural analgesia combined with general anesthesia on hemodynamics. Thirty patients undergoing surgery for the treatment of cancer of the neck were studied. The patients were divided into two groups of those who received epidural analgesia combined with general anesthesia group (Group 1) and those with general anesthesia alone (Group 2). Blood pressure was not different between the groups. But heart rate and rate pressure products in Group 1 were significantly lower than those of Group 2. CVP in Group 1 increased significantly to 10.1 +/- 2.9 mmHg during surgery from 6.8 +/- 1.8 mmHg at the beginning of the surgery. There was no difference in intraoperative blood loss and the amount of fluid infused between the two groups. These results suggest that epidural anesthesia combined with general anesthesia is effective to stabilize hemodynamics during cervical surgery, but we have to be careful about using local anesthetics during long cervical procedures, because it increases CVP which might result from the depression of cardiac function.
本研究的目的是探讨硬膜外镇痛联合全身麻醉对血流动力学的影响。对30例接受颈部癌症手术治疗的患者进行了研究。患者被分为两组，一组接受硬膜外镇痛联合全身麻醉（第1组），另一组仅接受全身麻醉（第2组）。两组之间血压无差异。但第1组的心率和心率血压乘积显著低于第2组。第1组的中心静脉压在手术开始时为6.8±1.8 mmHg，手术期间显著升高至10.1±2.9 mmHg。两组术中失血量和输液量无差异。这些结果表明，硬膜外麻醉联合全身麻醉在颈椎手术期间对稳定血流动力学有效，但在长时间颈椎手术中使用局部麻醉药时我们必须小心，因为它会增加中心静脉压，这可能是由于心功能抑制所致。
