Hemodynamic Effects of Epidural Analgesia for Gastrectomy in the Geriatric Patient

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m003000801004.pdf 615 KB エンバーゴ : 2015-10-18
タイトル
Hemodynamic Effects of Epidural Analgesia for Gastrectomy in the Geriatric Patient
著者
小坂 義弘
松井 一幸
西尾 祐二
椎原 康也
収録物名
Shimane journal of medical science
8
1
開始ページ 25
終了ページ 35
収録物識別子
ISSN 03865959
EISSN 24332410
内容記述
抄録・要旨
The hemodynamic effect of epidural analgesia supplemented with a small dose of sedatives was studied by Swan-Ganz Catheter method in fifteen geriatric patients from 65 to 80 years old with gastrectomy. No premedication was given to avoid its circulatory effects. From one venous route 5 ml/kg/hr of lactated Ringer solution and from the other hydroxyethyl starch at the same rate were infused. Epidural puncture was performed in the intervertebral space between T_8 and T_<10> and 6 to 8 ml of 2% mepivacaine were administered through the epidural catheter. Analgesia by epidural block 20 min later was in average from T_2 to L_1. Hemodynamic parameters were assessed before, 20 min after epidural block, and 5 and 20 min after diazepam (5mg). After 20 min of epidural analgesia, HR (-5%), MAP (-19%), SVR (-16%), and RPP (-28%) decreased significantly, while MPAP, CVP, CI, SVI and PVR did not change. Five minutes after diazepam, hemodynamic parameters decreased by 10% more. These changes, however, returned to the pre-administration level 20 min after diazepam. Though meticulous caution is needed for intraoperative management from a circulatory and respiratory standpoint, we consider epidural analgesia to be one of the recommendable anesthetic methods for the anesthesia of gastrectomy in elderly patients.
主題
epidural analgesia
hemodynamics
geriatric patient
言語
英語
資源タイプ 紀要論文
出版者
Shimane Medical University
発行日 1984-06-01
出版タイプ Version of Record(出版社版。早期公開を含む)
アクセス権 オープンアクセス
関連情報
[NCID] AA00841586