区域麻醉时交感神经系统的功能及其行为。

IF 1.9 Q2 POLITICAL SCIENCE Regional-Anaesthesie Pub Date : 1990-05-01
A Janitzki, A Götte
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引用次数: 0

摘要

交感神经系统的活动在人体重要功能的调节中起着至关重要的作用。交感神经影响的损害导致相当紊乱的效应功能,在某些情况下甚至完全失效。在临床上,这是非常重要的,因为如果一种麻醉剂产生导致交感神经系统阻塞,在个别情况下,其影响可能是严重的,特别是对心血管系统。如果要避免并发症,正确评估阻塞程度是至关重要的。临床监测有多种应用,其中特别有用的一种是在区域麻醉期间测量交感神经系统,对阻滞效应的量化是临床必需的,并且需要立即确定阻滞程度,例如在脊髓或硬膜外麻醉的情况下。交感神经系统的活动可以通过两种方式间接监测:通过测量皮肤温度的变化(参考所有循环参数),因为这些变化反映了它对小动脉的影响;通过测量由外阴汗腺引起的皮肤阻力,这也受交感神经系统的调节。由于系统的解剖和功能结构是高度复杂的,因此不能假设两种测量之间的联系。在脊髓麻醉期间同时测量这两个变量并进行分析。结果表明,这两种测量结果相关性很好,至少在统计的中间范围内,皮肤电阻是迄今为止两种测量方法中更快、更敏感的。
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[The function of the sympathetic nervous system and its behavior during regional anesthesia].

The activity of the sympathetic nervous system is of fundamental importance in the regulation of vital bodily functions. Impairment of sympathetic neuronal efferences results in considerably disordered effector function, and in some cases even in complete failure. Clinically, this is of great significance, because if an anesthetic agent produces cause the sympathetic system to block, the effects can be serious in individual cases, particularly on the cardiovascular system. If complications are to be avoided, it is essential to assess the degree of block correctly. Clinical monitoring has a variety of applications, a particularly useful one being measurement of the sympathetic system during regional anesthesia, for which quantification of the blocking effect is a clinical necessity and the degree of block needs to be ascertained without delay, for example in the case of spinal or peridural anesthesia. The activity of the sympathetic system can be monitored indirectly by two means: by measuring changes in skin temperature (with reference to all circulatory parameters), as these reflect its influence on the arterioles, and by measuring the skin resistance caused by the eccrinal sweat glands, which are also regulated by the sympathetic system. As the anatomical and functional structure of the system is highly complex a connection between the two measurements cannot necessarily be assumed. The two variables were measured simultaneously during spinal anesthesia and analysed. It was shown that the two measurements correlated well, at least in the statistical middle range, and that skin resistance was by far the faster and more sensitive of the two.

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CiteScore
3.50
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0.00%
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[An epidural spinal abscess as a lethal complication of peridural anesthesia]. [Knotting of a peridural catheter]. [A simple technique for estimating the level of analgesia in regional anesthesia]. [CSE--the combination of spinal and epidural anesthesia]. [Comments on the paper by R. Schürg et al. Maternal and neonatal plasma concentrations of bupivacaine during peridural anesthesia for cesarean section].
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