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Effect of Acute Sympathectomy by Epidural Anesthesia on the Canine Coronary Circulation

 

作者: Gerald Klassen,   R. Bramwell,   Philip Bromage,   Danuta Zborowska-Sluis,  

 

期刊: Anesthesiology  (OVID Available online 1980)
卷期: Volume 52, issue 1  

页码: 8-15

 

ISSN:0003-3022

 

年代: 1980

 

出版商: OVID

 

关键词: Anesthetic techniques, epidural;Heart: blood flow, myocardial;coronary occlusion;endocardium;vascular pressures;Measurement techniques: radioactive tracers;Sympathetic nervous system: adrenergic transmission;anesthesia

 

数据来源: OVID

 

摘要:

The effects of reversible sympathetic neural blockade of the canine myocardium under control conditions and in the presence of decreased coronary blood flow and after myocardial infarction were investigated in 17 dogs. A multiple-microsphere technique was used to measure distribution of blood flow in the myocardium. Epidural blockade was associated with the following changes in the ratio of endocardial to epicardial blood flow: under control conditions, no change; after 50 per cent decrease in coronary flow, 18 per cent increase in endocardial/epicardial ratio; after myocardial infarction at unrestricted coronary flow, 43 per cent ratio increase; after myocardial infarction and 50 per cent decrease in coronary flow, 76 per cent increase of endocardial/epicardial ratio. These effects appear to be independent of systemic factors, and may result from alterations in tone of transmural resistance vessels. In addition, cervicothoracic epidural blockade resulted in a decrease in systemic pressure and an increase in coronary vascular resistance as myocardial oxygen demand decreased. When systemic pressure was restored these effects were abolished. In the presence of myocardial infarction, epidural blockade had less effect on systemic pressure and left ventricular filling pressure was decreased. With decreased coronary flow, sympathetic blockade redistributed coronary blood flow, favoring the endocardium in both the normal and the infarcted heart.

 

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