THE EFFECTS OF 1/200,000 EPINEPHRINE CONTAINED IN LOCAL ANESTHETICS ON CARDIOVASCULAR SYSTEM IN OLD PATIENTS

为探讨局麻药中含有1/20万肾上腺素在异丙酚麻醉中对心血管系统的影响，将14例择期口腔颌面外科手术患者分为两组：以下组(I组)和65岁以上组(II组)。硫喷妥钠诱导麻醉，维库溴铵静脉滴注促进气管插管。给予氧气、一氧化二氮和异丙酚。当心血管和呼吸条件稳定后，注射含0.5%利多卡因的1/20万肾上腺素，用PORTAPRES模型-2每10秒测量一次血流动力学参数，收缩压、舒张压和平均压瞬间升高，注射后80秒显著下降，注射后110秒显著下降，注射后90秒心率增加，而注射后80秒心率保持不变，此后增加140秒。两组搏动间期均有缩短，注药后90s组起搏间期最大，差异有统计学意义，注药组起搏后140s，两组每搏输出量均有所增加，但与对照组比较差异无统计学意义。心输出量在注射后90s组显著增加，组II为130-210秒，两组排出时间均延长。结果表明，局麻药1/20万肾上腺素注射后，I组和II组的血流动力学变化有30~50秒的时间滞后。

The purpose of the present study was to investigate the effects of 1/200,000 epinephrine contained in local anesthetics on cardiovascular system during propofol anesthesia.Fourteen patients scheduled for oral and maxillofacial Surgery were divided into two groups ; the patients under 64 years old(group I) and over 65 years old(group II). Anesthesia was induced with thiopental IV, and tracheal intubation was facilitated with the IV adminstration of vecuronium. Oxygen, nitrous oxide, and propofol were administered. When cardiovascular and respiratory conditions were stabilized, 1/200,000 epinephrine contained in 0.5% lidocaine was administered, and the parameters of hemodynamics were measured for five minutes every ten seconds by PORTAPRES MODEL-2.Systolic, diastolic, and mean blood pressure increased transiently, then deceased significantly 80 sec after injection in the group I, and 110 sec in the group II.Heart rate increased 90 sec after injection in the group I, while, in the group II, it didn't change for 80 sec, since then, increased 140 sec after injection. Interbeat interval decreased in the both groups, maximum and significant changes were observed 90 sec after injection in the group I, 140 sec in the groupII.Stroke volume increased in the both groups, but there were no significant differences compared with the control value. Cardiac output increased significantly 90 sec after injection in the group I, 130-210 sec in the group II.Ejection time increased in the both groups. Total peripheral resistance decreased significantly 90 sec after injection in the group I, 130 sec in the group II.These results revealed that there was 30-50 sec time lag between groups I and II in hemodynamic changes after the administration of 1/200,000 epinephrine contained in local anesthetics.