This Article Résumé de cet Article Full Text Full Text (PDF) Submit a scholarly reply Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Funayama, T. Articles by Kumazawa, T. Search for Related Content PubMed PubMed Citation Articles by Funayama, T. Articles by Kumazawa, T.

Systemic, but not pulmonary, hemodynamics are depressed during combined high thoraco-cervical epidural and general anesthesia in dogs

[L’hémodynamique générale, mais non pulmonaire, est déprimée pendant l’anesthésie combinée péridurale haute thoraco-cervicale et générale chez les chiens]

Tadahisa Funayama, MD^*, Sumihisa Aida, MD PhD, Takashi Matsukawa, MD PhD^*, Kazuo Okada, MD PhD and Teruo Kumazawa, MD PhD^*

^* From the Departments of Anesthesiology, Faculty of Medicine, University of Yamanashi, Yamanashi;
Akiru Municipal General Hospital, Tokyo; and
Teikyo University School of Medicine, Tokyo, Japan.

Address correspondence to: Dr. Takashi Matsukawa, Department of Anesthesiology, Faculty of Medicine, University of Yamanashi, Yamanashi 409-3898, Japan. Phone: +81-55-273-9690; Fax: +81-55-273-6755; E-mail: takashim{at}res.yamanashi-med.ac.jp

Purpose: An epidural block is frequently combined with general anesthesia. Both systemic and pulmonary hemodynamics may be affected by high epidural anesthesia and the combined general anesthetic. These effects were investigated in a canine model.

Methods: Systemic and pulmonary hemodynamics during a combined high thoraco-cervical epidural and general anesthesia were studied in dogs; the animals were anesthetized with propofol, 10 mg•kg^-1•hr^-1, or 2% sevoflurane, and then 1% mepivacaine, 5 mL, was injected epidurally between T1 and T2. Cardiac output (CO), pulmonary capillary wedge pressure (PCWP), pulmonary arterial pressure (PAP), mean arterial pressure (MAP), central venous pressure (CVP), electrocardiogram, and arterial and mixed venous gases were monitored for over 90 min after epidural mepivacaine. The interval between sevoflurane and propofol studies was two hours.

Results: Baseline measurement of MAP with sevoflurane anesthesia was significantly lower (P < 0.05–0.01) at every time point than with propofol anesthesia. After epidural mepivacaine (C1)-T7/8 blockade), MAP (P < 0.05–0.01), CO (P < 0.05–0.01), and heart rate (P < 0.05–0.01) decreased significantly during both propofol and sevoflurane anesthesia. In the sevoflurane group, stroke volume decreased significantly (P < 0.05–0.01) but recovered; however, MAP (P < 0.01) and CO (P < 0.05) did not recover 90 min after the injection. Mean CVP and systemic vascular resistance were not altered. There were no changes in mean PAP, mean PCWP, and pulmonary vascular resistance.

Conclusion: A combined high thoracic/general anesthesia depressed systemic hemodynamics, whereas the pulmonary circulation was not affected. The extent of the depression varied with the general anesthetics used, sevoflurane and propofol.

This article has been cited by other articles:

				H. L.A. van den Oever, M. Dzoljic, C. Ince, M. W. Hollmann, and F. C. Mokken Orthogonal polarization spectral imaging of the microcirculation during acute hypervolemic hemodilution and epidural lidocaine injection. Anesth. Analg., August 1, 2006; 103(2): 484 - 7, table of contents. [Abstract] [Full Text] [PDF]

				M. Roussier, P. Mahul, J. Pascal, D. Baylot, J. M. Prades, C. Auboyer, and S. Molliex Patient-controlled cervical epidural fentanyl compared with patient-controlled i.v. fentanyl for pain after pharyngolaryngeal surgery Br. J. Anaesth., April 1, 2006; 96(4): 492 - 496. [Abstract] [Full Text] [PDF]