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language
eng
Author
Kosaka, Yoshihiro
Matsui, Kazuyuki
Nishio, Yuji
Shiihara, Kohya
Description
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.
Subject
epidural analgesia
hemodynamics
geriatric patient
Journal Title
Shimane journal of medical science
Volume
8
Issue
1
Start Page
25
End Page
35
ISSN
03865959
ISSN(Online)
24332410
Published Date
1984-06-01
NCID
AA00841586
Publisher Aalternative
Shimane Medical University
NII Type
Departmental Bulletin Paper
Format
PDF
Text Version
出版社版
OAI-PMH Set
Faculty of Medicine