Kasaba T, Katsuki H, Taniguchi M, Takasaki M
Department of Anesthesiology, Miyazaki Medical College.
Masui. 1996 Oct;45(10):1260-4.
The choice of epidural anesthesia for patients with bronchial asthma is controversial. We used epidural anesthesia during surgery in 16 cases of asthma. Epidural anesthesia produced by 1% or 2% lidocaine or mepivacaine without epinephrine did not induce asthmatic attack in any patients. After epidural block, general anesthesia was induced with midazolam and vecuronium and endotracheal tube was inserted in 9 patients. Asthmatic attack occurred in two patients. In one patient it occurred by the endotracheal intubation and in another patient during thyroidectomy under nitrous oxide - oxygen - sevoflurane anesthesia, although no attack was observed in 7 patients. Two patients were considered to be in severe state of bronchial asthma and they had been on steroid drug and inhalation therapy before surgery. Both patients recovered soon with antiasthmatic therapy. These results suggest that epidural anesthesia has little or no relevance to asthmatic attack.
支气管哮喘患者选用硬膜外麻醉存在争议。我们对16例哮喘患者在手术期间使用了硬膜外麻醉。由1%或2%利多卡因或甲哌卡因(不含肾上腺素)产生的硬膜外麻醉未在任何患者中诱发哮喘发作。硬膜外阻滞完成后,9例患者使用咪达唑仑和维库溴铵诱导全身麻醉并插入气管导管。2例患者发生哮喘发作。1例患者在气管插管时发作,另1例患者在氧化亚氮-氧气-七氟醚麻醉下行甲状腺切除术期间发作,不过7例患者未观察到发作。2例患者被认为处于支气管哮喘严重状态,术前一直在接受类固醇药物和吸入治疗。两名患者经抗哮喘治疗后很快康复。这些结果表明硬膜外麻醉与哮喘发作几乎没有关联。