Cardiac Sympathovagal Balance and Peripheral Sympathetic Vasoconstriction: Epidural Versus General Anesthesia
Cardiac Sympathovagal Balance and Peripheral Sympathetic Vasoconstriction: Epidural Versus General Anesthesia
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心脏交感神经平衡和外周交感血管收缩：硬膜外麻醉与全身麻醉
DOI：
10.1213/00000539-199407000-00031
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发表时间：
1994
影响因子：
5.7
通讯作者：
S. Raja
中科院分区：
文献类型：
--
作者：
L. Fleisher;S. Frank;Y. Shir;M. Estafanous;S. Kelly;S. Raja
硬膜外麻醉和全身麻醉都能改变自主神经平衡。然而，硬膜外（EA）和全身麻醉药（GA）之间的相对差异，心脏和外周交感迷走神经平衡尚未被描述。连续20例计划行根治性耻骨后尿道切除术的患者随机接受EA（n = 10）或GA（n = 10）。以低频（0.05-0.125 Hz）/高频（0.125-0.5 Hz）功率比值作为心脏交感迷走神经平衡的指标，对心电图进行功率谱分析。前臂减去指尖的皮肤表面温度梯度（>4°C）被用作交感神经介导的外周血管收缩的指标。在术中，EA组的患者表现出明显更大的低频/高频功率比和更频繁的外周血管收缩的发生率比GA组。在术后期间，GA组表现出相对于术中期间的低/高比率和血管收缩发生率增加。术中，上身血管收缩似乎伴随着心脏交感迷走神经平衡的显着转变，交感神经优势与EA相对GA。术后，GA与交感迷走神经平衡向交感神经优势的转变有关。需要进一步的研究来确定这是否会导致高风险患者的心血管损害。
Both epidural and general anesthetics alter autonomic balance. However, the relative differences between epidural (EA) and general anesthetics (GA) with regard to cardiac and peripheral sympathovagal balance have not been described. Twenty consecutive patients scheduled for radical retropubic prostatectomy were randomized to receive EA (n = 10) or GA (n = 10). Power spectral analysis was performed on the electrocardiographic recordings, with the ratio of low (0.05–0.125 Hz)/high (0.125–0.5 Hz) frequency power used as an index of cardiac sympathovagal balance. The forearm minus fingertip skin-surface temperature gradient (>4°C) was used as an indicator of sympathetically mediated peripheral vasoconstriction. Patients in the EA group demonstrated a significantly greater low/high frequency power ratio and a more frequent incidence of peripheral vasoconstriction than the GA group during the intraoperative period. During the postoperative period, the GA group demonstrated an increase in the low/high ratio and the incidence of vasoconstriction relative to the intraoperative period. Intraoperatively, upper body vasoconstriction appears to be accompanied by a significant shift in cardiac sympathovagal balance toward sympathetic predominance with EA relative to GA. Postoperatively, GA is associated with a shift in the sympathovagal balance toward sympathetic predominance. Further research is required to determine whether this results in cardiovascular compromise in the high-risk patient.
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影响因子：
56.9
作者：
AKSELROD, S;GORDON, D;COHEN, RJ
通讯作者：
COHEN, RJ
DOI：
10.1016/0735-1097(91)91208-v
发表时间：
1991-02
期刊：
The American journal of cardiology
影响因子：
--
作者：
R. Kleiger;J. Bigger;M. Bosner;M. Chung;J. Cook;L. Rolnitzky;R. Steinman;J. Fleiss
通讯作者：
R. Kleiger;J. Bigger;M. Bosner;M. Chung;J. Cook;L. Rolnitzky;R. Steinman;J. Fleiss
DOI：
10.1016/0735-1097(89)90408-7
发表时间：
1989-11-01
影响因子：
24
作者：
APPEL, ML;BERGER, RD;COHEN, RJ
通讯作者：
COHEN, RJ
影响因子：
8.8
作者：
RUBINSTEIN, EH;SESSLER, DI
通讯作者：
SESSLER, DI