| Co-Investigator(Kenkyū-buntansha) |
AGUNE Tadashi Miyazaki Medical College,Instructor, 医学部, 助手 (90202564)
YOSHIYAMA Kenichi Miyazaki Medical College,Instructor, 医学部, 助手 (90230820)
YOSHIKAWA Gohtaro Miyazaki Medical College,Instructor, 医学部, 助手 (20220600)
|
|---|
| Budget Amount *help |
¥1,500,000 (Direct Cost: ¥1,500,000)
Fiscal Year 1991: ¥300,000 (Direct Cost: ¥300,000)
Fiscal Year 1990: ¥1,200,000 (Direct Cost: ¥1,200,000)
|
|---|
| Research Abstract |
Background: The beneficial effects of thoracic epidural anesthesia on survival and physiologic functions during hemorrhagic shock have been shown in animals but have not been supported universally. This study was designed to clarify differences between epidural and halothane anesthesia and between upper thoracic and thoracolumbar epidural anesthesia in hemodynamic and metabolic responses to hemorrhage in dogs. Methods: Group 1 of seven dogs received 0.2% halothane anesthesia, group 2 of six received 0.2% halothane plus epidural anesthesia ranged from C_4 to T_5, group 3 of seven received 0.2% halothane plus epidural anesthesia ranged from C_5 to L_7, and group 4 of eight received 0.9% halothane anesthesia. After blood removal (35 ml・kg^<-1>) for 30 min, hemodynamic, metabolic and catecholamine variables were measured repeatedly at 30-min intervals for 2h.
Results: Two dogs in group 1 died 1 h after hemorrhage but all dogs in the other groups survived. The mean arterial pressure, pulmona
… More
ry capillary wedge pressure, central venous pressure and cardiac output decreased significantly in all groups. However, the decrease in mean arterial pressure was significantly larger in group 3 than in groups 1,2 and 4. The heart rate increased significantly rapidly in group 1 and slowly in group 4, but decreased significantly in group 3. In group 2, it remained unchanged. Arterial pH and base excess decreased significantly in all groups. After that, base excess recovered slowly in groups 2 and 4 but decreased further in groups 1 and 3. The plasma epinephrine concentration increased significantly and stayed at higher level in group 1. In groups 2 and 4, it also increased but decreased slowly. In group 3, it remained unchanged. The plasma norepinephrine concentration increased significantly markedly in group 1. In groups 2 and 4, it increased moderately. In group 3, it remained unchanged. The hemodynamic, metabolic and catecholamine variables during hemorrhagic shock were maintained better in groups 2 and 4 than in groups 1 and 3 in the single-withdrawal hemorrhagic models.
Conclusions: The hemodynamic, metabolic and catecholamine responses to hemorrhagic shock under upper thoracic epidural anesthesia were similar to those under 1 MAC halothane anesthesia. However, widespread epidural anesthsia or light halothane anesthesia worsened the hemodynamic and metabolic parameters during hemorrhagic shock. Less
|
