Japanese |
Title | 神経ブロックの併用は術中の血圧変動を緩和する |
Subtitle | 原著 |
Authors | 柏野繁雄, 山根真央, 橘かおり, 久野健二郎, 加藤潤, 劔物修 |
Authors(kana) | |
Organization | 北海道大学医学部附属病院麻酔科 |
Journal | 循環制御 |
Volume | 23 |
Number | 1 |
Page | 14-16 |
Year/Month | 2002/ |
Article | 報告 |
Publisher | 日本循環制御医学会 |
Abstract | 肩や上肢の手術に対して腕神経叢ブロックを併用した全身麻酔が選択される. 神経ブロックを併用すると全身麻酔単独の麻酔方法の場合と比較して術中の血圧変動が少ないように思われる. しかし, evidence-based medicineの観点から定量的に比較した報告は見あたらないようである. 本研究は術中血圧変動に与える神経ブロックの影響をretrospectiveに検討した. 対象と方法 最近6年間(1/1/1995-12/31/2000)に当院で全身麻酔下に手術を受けた整形外科の成人症例を対象とした. 該当する2,127例のうち, 片側の肩や上肢に限定した手術例であり, 身体のほかの部位より腸骨, 神経, 皮膚などを採取, 移植を行った例や手術時間が4時間以上に及んだ症例を除外した339例が, 当院手術部で稼動している電子化麻酔記録システムHODMS1)のデータベースより抽出された. このうち全身麻酔単独の102例(単独群)に対して腕神経叢ブロック併用例は237例であった. |
Practice | 基礎医学・関連科学 |
Keywords | Nerve block, Brachial plexus block, Blood pressure variance, Automated anesthesia record, Anesthesia |
English |
Title | Combination of Brachial Plexus Block Attenuates the Variance of Blood Pressure During Surgery Under General Anesthesia |
Subtitle | |
Authors | Shigeo Kaseno, Masahiro Yamane, Kaori Tachibana, Kenjiro Hisano, Jun Kato, Osamu Kemmotsu |
Authors(kana) | |
Organization | Department of Anesthesiology, Hokkakido University Hospital |
Journal | Circulation Control |
Volume | 23 |
Number | 1 |
Page | 14-16 |
Year/Month | 2002/ |
Article | Report |
Publisher | Japan Society of Circulation Control |
Abstract | We retrospectively investigated the variance of systolic or mean blood pressure (SBP, MBP) during surgery of the shoulder or upper extremities in adult patients anesthetized by sevoflurane/N2O and combined brachial plexus block (group A;n=112) and those anesthetized by sevoflurane/N2O alone (group B;n=102). The lability of blood pressue of 214 patients was assessed with both lability index(LI) and fluctuation index(FI) which was proposed by the authors. Values of LI and FI of SBP were 0.018±0.01 and 7.56±3.66 for group A, and 0.028±0.02 and 8.86±3.84 for group B. Values of LI and FI of MBP were 0.018± 0.01 and 7.56±3.66 for group A, and 0.028±0.02 and 8.86±3. 84 (mean±SDM) for group B. Blood pressure variance in group A showed 15% by L.I. and 25% by F.I. which were less than that in group B. Our data suggest combination of nerve block with general anesthesia is more preferable and appropriate to avoid blood pressure variance during surgery. |
Practice | Basic medicine |
Keywords | Nerve block, Brachial plexus block, Blood pressure variance, Automated anesthesia record, Anesthesia |