Japanese
Title大腿骨頭置換術中に見られる迷走神経様反射
Subtitle原著
Authors永井一成*, 茂木浩子**
Authors(kana)
Organization*国立相模原病院麻酔科, **北里大学医学部外科
Journal循環制御
Volume11
Number4
Page523-529
Year/Month1990/
Article原著
Publisher日本循環制御医学会
Abstract「要旨」股関節全置換術など大腿骨頭置換術中の循環系の抑制は, 多くの場合は骨セメント使用時に見られ, その原因として骨セメントの溶媒あるいは肺の塞栓症であろうと考えられている. われわれは, 過去4年半の間に, 大腿骨骨髄掻爬138例中に一過性の急激な血圧低下と徐脈を起こした11症例を経験したのでレトロスペクティブに調査検討を行った. 循環抑制の原因としては骨セメント及びその溶媒や, 微小肺塞栓は考え難く, 坐骨神経を介した副交感神経様反射が強く疑われた.
Practice基礎医学・関連科学
Keywordsfemoral head replaoement, cardiovascular collapse, parasympathetic nerve reflex
English
TitleSuspected parasympathetic nerve reflex during femoral head replacement surgery
Subtitle
AuthorsKazushige Nagai*, Hiroko Mogi**
Authors(kana)
Organization*Department of Anesthesiology Sagamihara National Hospital, **Department of Surgery Kitasato University Hospital
JournalCirculation Control
Volume11
Number4
Page523-529
Year/Month1990/
ArticleOriginal article
PublisherJapan Society of Circulation Control
AbstractSudden cardiovascular changes in 138 patients who underwent femoral head replacement surgery were studied retrospectively. All operations were performed under epidural analgesia with the patients awake and breathing room air, All patients received multiple doses of 2% mepivacaine via a lumbar epidural catheter just prior to surgery. The medullary cavity of the femur was opened and widened with tapered reamers. In 11 patients, marked hypotension and bradycardia occurred just after impaction of the femoral medulla reamer into the medullary cavity. This cardiovascular change may have resulted from a parasympathetic reflex to expansion of the femoral periosteum or to traction of the sciatic nerve. In conclusion, we recommened complete anesthesia, of the sacral nerves when epidural anesthesia is given during femoral head replacement.
PracticeBasic medicine
Keywordsfemoral head replaoement, cardiovascular collapse, parasympathetic nerve reflex

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