The Effects of Subarachnoid Lidocaine and Phenylephrine on Spinal Cord and Cerebral Blood Flow in Dogs
The Effects of Subarachnoid Lidocaine and Phenylephrine on Spinal Cord and Cerebral Blood Flow in Dogs
复制标题
蛛网膜下腔利多卡因和去氧肾上腺素对犬脊髓和脑血流量的影响
DOI：
10.1097/00000542-198409000-00002
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发表时间：
1984
期刊：
影响因子：
8.8
通讯作者：
H. Naito
中科院分区：
文献类型：
--
作者：
S. Dohi;N. Matsumiya;R. Takeshima;H. Naito
为探讨腰麻时中枢神经系统的循环情况，采用氢清除技术同时测定了蛛网膜下腔利多卡因、苯肾上腺素或两者联合应用后局部脊髓血流量（SCBF）和脑血流量（CBF）。在氟烷轻度麻醉的犬中，SCBF和CBF的平均对照值分别为22.4 ± 7.9 ml·100 g-1·min-1和53.1 ± 12.0 ml·100 g-1·min-1，蛛网膜下腔注射1 ml利多卡因溶液（1、2、3和5%）对SCBF无统计学显著性变化（P > 0.05）。蛛网膜下腔注射苯肾上腺素（0.1，0.2，0.3，0.5%）1 ml，浓度大于0.2%时，SCBF显著降低（P < 0.05）。当利多卡因（24 mg）和苯肾上腺素（1 mg）的混合物注入蛛网膜下腔时，SCBF显著降低，并在60-90 min内恢复到对照水平。CBF在任何注射中均无显著变化，保持在对照水平的±12%以内。用于稀释药物的葡萄糖水溶液（5%和7.5%）不影响SCBF或CBF。这些结果表明，在脊髓麻醉过程中，当苯肾上腺素加入局部麻醉液中时，局部脊髓血流会受到显着影响。然而，注射到脊髓蛛网膜下腔的药物的循环效应似乎仅限于局部脊髓本身，不涉及CNS的其他部分。
To investigate the central nervous system circulation during spinal anesthesia, local spinal cord blood flow (SCBF) and cerebral blood flow (CBF) were measured simultaneously by the hydrogen clearance technique following subarachnoid lidocaine, phenylephrine, or a combination of both. The mean control values of SCBF and CBF were 22.4 ± 7.9 ml.100 g−1·min−1 and 53.1 ± 12.0 ml·100 g−1·min−1, respectively, in dogs lightly anesthetized with halothane.The subarachnoid administration of lidocaine solutions (1, 2, 3, and 5%), 1 ml, failed to produce statistically significant changes in SCBF (P > 0.05). Whereas, when phenylephrine (0.1, 0.2, 0.3, and 0.5%), 1 ml, was injected into the spinal subarachnoid space, SCBF decreased significantly with concentrations greater than 0.2% (P < 0.05). When a mixture of lidocaine (24 mg) and phenylephrine (1 mg) was administered into the subarachnoid space, SCBF decreased significantly and returned to control within 60–90 min. CBF did not change significantly with any of the injections, remaining within less than ±12% of control. Dextrose solutions in water (5 and 7.5%), which were used for dilution of the drugs, did not affect either SCBF or CBF. These results indicate that local spinal cord blood flow can be affected significantly during spinal anesthesia when phenylephrine is added to the local anesthetic solution. However, the circulatory effects of drugs injected into the spinal subarachnoid space appear to be restricted to the local spinal cord per se and do not involve other parts of the CNS.