Document Detail


The effects of volume loading during epidural analgesia.
MedLine Citation:
PMID:  2996099     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We have determined the effects of volume loading on the cardiovascular changes during epidural analgesia in 37 patients, who underwent various kinds of surgery. The patients were placed in 4 groups, depending upon the level of analgesia and utilization of volume loading with colloidal solutions. If the analgesia extended above Th4 we grouped them as "high epidural" and lower than Th5 level they were grouped as "low epidural". The cardiac output was measured through a Swan-Ganz catheter with thermo-dilution methods and cardiovascular variables were calculated by standard formulas. Under epidural block the most significant changes were a fall in blood pressure with decrease in cardiac output which were more pronounced during high epidural analgesia. Volume loading during the induction period with colloidal solutions would prevent the marked fall of blood pressure in half of cases studied, but in the other half the infusion was not effective for the prevention of fall in blood pressure. On every occasion over-loading effects on the right side of the heart were observed with the infusion of colloidal solutions. Also, a marked fall in systemic vascular resistance was observed with the infusion. In consequence the volume loading did not prevent the fall in arterial pressure. To manage the latter which was observed during epidural block, some sympathomimetic agents would be necessary with the volume loading. This approach would be much more important in patients with dehydration and high level of epidural analgesia.
Authors:
N Nishimura; Y Kajimoto; T Kabe; A Sakamoto
Related Documents :
2124409 - Metabolic and cardiovascular responses following oral and nasal intubation of the trachea.
19370949 - Pressor responses following insertion of laryngeal mask airway in patients with control...
23849709 - High-frequency oscillatory ventilation in children with acute respiratory distress synd...
2278329 - Pressure generated during insertion of lumbar epidurals. a comparison with the portex e...
2524949 - A study of epidural morphine and sufentanil anesthesia for abdominal aortic surgery.
24173479 - Evaluation of gasometric parameters in trauma patients during mobile prehospital care.
2897199 - Nephrectomy-induced alterations in the synthesis of catecholamines in the sympathetic n...
21736449 - Age dependency of central and peripheral systolic blood pressures: cross-sectional and ...
15857169 - Normocapnic high-frequency oscillatory ventilation affects differently extrapulmonary a...
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Resuscitation     Volume:  13     ISSN:  0300-9572     ISO Abbreviation:  Resuscitation     Publication Date:  1985 Jun 
Date Detail:
Created Date:  1985-11-12     Completed Date:  1985-11-12     Revised Date:  2009-08-25    
Medline Journal Info:
Nlm Unique ID:  0332173     Medline TA:  Resuscitation     Country:  IRELAND    
Other Details:
Languages:  eng     Pagination:  31-40     Citation Subset:  IM    
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Anesthesia, Epidural*
Blood Pressure*
Cardiac Output*
Colloids
Female
Fluid Therapy*
Humans
Hypotension / prevention & control*
Isotonic Solutions / therapeutic use
Male
Mepivacaine
Middle Aged
Preanesthetic Medication
Vascular Resistance
Chemical
Reg. No./Substance:
0/Colloids; 0/Isotonic Solutions; 8022-63-7/Ringer's lactate; 96-88-8/Mepivacaine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Hemofiltration in severe high microvascular permeability pulmonary edema secondary to rickettsial sp...
Next Document:  Five years experience of cardiopulmonary resuscitation in a children's hospital.