Capelozzi M, Arantes F M, Paiva P S, Capelozzi V L, Martins M A
Department of Pathology, School of Medicine, Clinics Hospital, University of Sao Paulo, Brazil.
Anesth Analg. 1998 Oct;87(4):874-8.
It has been postulated that regional anesthesia, when feasible, is the best anesthetic approach in asthmatic patients. However, there are reports of severe bronchospasm during regional anesthesia. In the present study, we developed an experimental model of spinal (subarachnoid) anesthesia in guinea pigs and studied respiratory system responsiveness to aerosolized methacholine. The animals received sodium pentobarbital (50 mg/kg intraperitoneally), a tracheotomy, and mechanical ventilation. Four groups of animals were studied: guinea pigs that received spinal anesthesia with lidocaine (500 microL of 2% solution) (n = 7); guinea pigs that received spinal administration of isotonic sodium chloride solution (500 microL) (n = 7); guinea pigs that received an intraperitoneal injection of lidocaine (500 microL of 2% solution) (n = 6); and control guinea pigs (n = 7). The concentration of methacholine chloride that resulted in 50% of the maximal value of respiratory system elastance was lower in guinea pigs that received spinal anesthesia compared with the other three groups (P < 0.005 for control group, P < 0.01 for spinal saline group, and P < 0.05 for intraperitoneal lidocaine group). Our results suggest that spinal anesthesia results in an increase in pulmonary responsiveness to bronchoconstrictive stimuli.
Regional anesthesia has been considered the best anesthetic approach in asthmatic patients, although there are reports of severe bronchospasm. We developed an experimental model of spinal anesthesia with lidocaine in guinea pigs and studied respiratory responsiveness to methacholine, a bronchoactive agonist. Spinal anesthesia resulted in an increase in respiratory responsiveness.
据推测，在可行的情况下，区域麻醉是哮喘患者最佳的麻醉方法。然而，有区域麻醉期间发生严重支气管痉挛的报告。在本研究中，我们建立了豚鼠脊髓（蛛网膜下腔）麻醉的实验模型，并研究了呼吸系统对雾化乙酰甲胆碱的反应性。动物接受戊巴比妥钠（50mg/kg腹腔注射）、气管切开术和机械通气。研究了四组动物：接受利多卡因脊髓麻醉（2%溶液500μL）的豚鼠（n = 7）；接受脊髓注射等渗氯化钠溶液（500μL）的豚鼠（n = 7）；接受腹腔注射利多卡因（2%溶液500μL）的豚鼠（n = 6）；以及对照豚鼠（n = 7）。与其他三组相比，接受脊髓麻醉的豚鼠导致呼吸系统弹性最大值50%时的乙酰甲胆碱氯浓度更低（对照组P < 0.005，脊髓生理盐水组P < 0.01，腹腔注射利多卡因组P < 0.05）。我们的结果表明，脊髓麻醉导致肺部对支气管收缩刺激的反应性增加。
尽管有严重支气管痉挛的报告，但区域麻醉一直被认为是哮喘患者最佳的麻醉方法。我们建立了豚鼠利多卡因脊髓麻醉的实验模型，并研究了对支气管活性激动剂乙酰甲胆碱的呼吸反应性。脊髓麻醉导致呼吸反应性增加。
