Shichinohe Y, Masuda Y, Takahashi H, Kotaki M, Omote T, Shichinohe M, Namiki A
Division of Anesthesiology, Asahikawa Red Cross Hospital.
Masui. 1993 Oct;42(10):1470-6.
We evaluated the influence of epidural and spinal anesthesia on VO2 and VCO2 measured by the indirect calorimetry. According to the spreading of anesthetic level, VO2, VCO2 and EE increased in the epidural group (EP group), but they decreased in spinal group (SP group). RQ was unchanged in both groups. Rate pressure product (RPP), in proportion to the MVO2 and the REE, did not correlate with the EE. The VO2, VCO2 and EE in EP group increased probably because; (1) epidural anesthesia does not affect the VO2 change, as it does not markedly suppress respiration; (2) cardiac stroke work is retained during epidural anesthesia, as it does markedly suppress circulation. In conclusion, epidural anesthesia exerts less influence on the respiratory and circulatory systems of patients compared with spinal anesthesia.
我们评估了硬膜外麻醉和脊髓麻醉对通过间接测热法测量的VO2和VCO2的影响。根据麻醉平面的扩散情况，硬膜外组（EP组）的VO2、VCO2和能量消耗（EE）增加，但脊髓组（SP组）的这些指标下降。两组的呼吸商（RQ）均未改变。与每分心输出量（MVO2）和静息能量消耗（REE）成比例的心率血压乘积（RPP）与能量消耗不相关。EP组的VO2、VCO2和EE增加可能是因为：（1）硬膜外麻醉不影响VO2的变化，因为它不会明显抑制呼吸；（2）硬膜外麻醉期间心脏搏出功得以保留，因为它不会明显抑制循环。总之，与脊髓麻醉相比，硬膜外麻醉对患者呼吸和循环系统的影响较小。
