Effect of High Thoracic Epidural Anesthesia on Ventilatory Response to Hypercapnea in Normal Volunteers
Ventilatory pattern (VP) and the hypercapnic ventilatory response (HVR) were investigated in thirteen healthy male volunteers before and after high thoracic epidural anesthesia (HTE) with 1% lidocaine in 6 subjects and 2% lidocaine in the others. Ventilatory variables were determined by pneumotachog...
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| Published in | Nihon Rinshō Masui Gakkai shi Vol. 11; no. 2; pp. 200 - 206 |
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| Main Authors | , , , , |
| Format | Journal Article |
| Language | English |
| Published |
THE JAPAN SOCIETY FOR CLINICAL ANESTHESIA
1991
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| Online Access | Get full text |
| ISSN | 0285-4945 1349-9149 |
| DOI | 10.2199/jjsca.11.200 |
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| Abstract | Ventilatory pattern (VP) and the hypercapnic ventilatory response (HVR) were investigated in thirteen healthy male volunteers before and after high thoracic epidural anesthesia (HTE) with 1% lidocaine in 6 subjects and 2% lidocaine in the others. Ventilatory variables were determined by pneumotachograph and respiratory inductive plethysmograph (RIP). RIP allowed us to partition the volume change of the lung into the rib cage component and the abdominal one. In resting condition, all parameters were unchanged after HTE with 1% lidocaine. By contrast, after HTE with 2% lidocaine significantly decreased duration of inspiration and volume displacement of the rib cage, and produced significant increase of mean inspiratory flow rate and minute ventilation. Partial pressure of end-tidal CO2 and volume displacement of the abdomen were essentially unchanged. HVR was not altered with HTE with 1% lidocaine, whereas it decreased significantly with 2% lidocaine due entirely to the decrease of the slope of the rib cage component. In both cases, the slope of the abdominal component was un-changed. In summary HTE with 1% lidocaine affected neither VP nor HVR. However, HTE with 2% lidocaine caused significant ventilatory changes. HTE with 2% lidocaine may have a notable effect on the efferent and/or afferent pathway of the intercostal nerve roots. |
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| AbstractList | Ventilatory pattern (VP) and the hypercapnic ventilatory response (HVR) were investigated in thirteen healthy male volunteers before and after high thoracic epidural anesthesia (HTE) with 1% lidocaine in 6 subjects and 2% lidocaine in the others. Ventilatory variables were determined by pneumotachograph and respiratory inductive plethysmograph (RIP). RIP allowed us to partition the volume change of the lung into the rib cage component and the abdominal one. In resting condition, all parameters were unchanged after HTE with 1% lidocaine. By contrast, after HTE with 2% lidocaine significantly decreased duration of inspiration and volume displacement of the rib cage, and produced significant increase of mean inspiratory flow rate and minute ventilation. Partial pressure of end-tidal CO2 and volume displacement of the abdomen were essentially unchanged. HVR was not altered with HTE with 1% lidocaine, whereas it decreased significantly with 2% lidocaine due entirely to the decrease of the slope of the rib cage component. In both cases, the slope of the abdominal component was un-changed. In summary HTE with 1% lidocaine affected neither VP nor HVR. However, HTE with 2% lidocaine caused significant ventilatory changes. HTE with 2% lidocaine may have a notable effect on the efferent and/or afferent pathway of the intercostal nerve roots. |
| Author | HAGIYA, Masato KOCHI, Tetsuo MIZOGUTI, Tadanobu OKUBO, Shuichi MORINARI, Hajime |
| Author_xml | – sequence: 1 fullname: OKUBO, Shuichi organization: Department of Respiratory Disease, Tokyo Teisin Hospital – sequence: 1 fullname: KOCHI, Tetsuo organization: Department of Anesthesiology, Chiba University School of Medicine – sequence: 1 fullname: MORINARI, Hajime organization: Department of Respiratory Disease, Tokyo Teisin Hospital – sequence: 1 fullname: HAGIYA, Masato organization: Department of Anesthesiology, Chiba University School of Medicine – sequence: 1 fullname: MIZOGUTI, Tadanobu organization: Department of Anesthesiology, Chiba University School of Medicine |
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| References | 15) Milic-Emili J, Grunstein MM :Drive and timing compornents of ventilation. Chest 70 (Suppl): 131-133, 1976 6) Takasaki M, Takahashi T: Respiratory function during cervical and thoracic extradural analgesia in patients with normal lungs. Br J Anaesth 52: 1271-1275, 1980 3) Remmers JE: Inhibition of inspiratory activity by intercostal muscle afferents. Respiration Phisiology 10: 358-383, 1970 13) Labaille T, Clergue F, Ecoffey C, et al.: Ventilatory response to CO2 following intravenous and epidural lidocaine. Anesthesiology 63: 179-183, 1985 2) Taylor A: Contribution of the intercostal muscles to the effort of respiration in man. Journal of Physiology (London) 151: 390-402, 1960 8) McCarthy GS: The effect of thoracic extradural analgesia on pulmonary gas distribution, functional residual capacity and airway closure. Br J Anaesth 48: 243-248, 1976 17) Druz WS, Sharp JT: Activity of respiratory muscles in upright and recumbent humans. J Appl Physiol 51: 1552-1561, 1981 1) Campbell EJM, Agostoni E, Newsom-Davis J: The respiratory muscles. In: Mecanics and Neural Con-trol. Philadelphia and London: W.B. Saunders, 1970 4) Critchlow V, von Euler C: Rhythmic control of inter-costal muscle spindles. Experimentia 18:426-427, 1962 9) Wahba WM, Craig DB, Don HF,et al.: The cardio-respiratory effects of thoracic epidural anesthesia. Can Anaesth Soc J 19: 8-19, 1972 12) Gross JB, Coldwell CB, Shaw LH, et al.: The effect of lidocaine on the ventilatory response to carbon diox-ide. Anesthesiology 59: 521-525, 1983 7) Sundberg A, Wattvil M, Arvill A: Respiratory effects of high thoracic epidural anesthesia. Acta Anaesth-esiol Scand 30: 215-217, 1986 11) van Luteren E, Cherniack NS: Electorical and mechanical activity of respiratory muscles during hypercapnea. J Appl Physiol 61: 719-727, 1986 16) Sharp JT, Goldberg NB, Druz WS, et al.: Relative cotribution of rib cage and abdomen to breathing in normal subjects. J Appl Physiol 39: 608-618, 1975 18) Bromage PR: Physiology and pharmacology of epidural analgesia. Anesthesiology 28: 592-622, 1967 14) Miller: Anesthesia second edition Vol.2,section V, 31, Churchill Livingstone, New York, Edinburgh, Lon-don, Melborne 1986, p.1061-1111 10) Read DJC: Aclinical method for assessing the ventilatory response to carbon dioxide. Australian Ann Med 16: 20-32, 1966 5) Gautier H: Respiratory responses of the anesthetized rabbit to vagotomy and thoratic dorsal rhizotomy. Respiration Physiology 17: 238-247, 1973 |
| References_xml | – reference: 16) Sharp JT, Goldberg NB, Druz WS, et al.: Relative cotribution of rib cage and abdomen to breathing in normal subjects. J Appl Physiol 39: 608-618, 1975 – reference: 14) Miller: Anesthesia second edition Vol.2,section V, 31, Churchill Livingstone, New York, Edinburgh, Lon-don, Melborne 1986, p.1061-1111 – reference: 6) Takasaki M, Takahashi T: Respiratory function during cervical and thoracic extradural analgesia in patients with normal lungs. Br J Anaesth 52: 1271-1275, 1980 – reference: 15) Milic-Emili J, Grunstein MM :Drive and timing compornents of ventilation. Chest 70 (Suppl): 131-133, 1976 – reference: 18) Bromage PR: Physiology and pharmacology of epidural analgesia. Anesthesiology 28: 592-622, 1967 – reference: 5) Gautier H: Respiratory responses of the anesthetized rabbit to vagotomy and thoratic dorsal rhizotomy. Respiration Physiology 17: 238-247, 1973 – reference: 8) McCarthy GS: The effect of thoracic extradural analgesia on pulmonary gas distribution, functional residual capacity and airway closure. Br J Anaesth 48: 243-248, 1976 – reference: 9) Wahba WM, Craig DB, Don HF,et al.: The cardio-respiratory effects of thoracic epidural anesthesia. Can Anaesth Soc J 19: 8-19, 1972 – reference: 12) Gross JB, Coldwell CB, Shaw LH, et al.: The effect of lidocaine on the ventilatory response to carbon diox-ide. Anesthesiology 59: 521-525, 1983 – reference: 7) Sundberg A, Wattvil M, Arvill A: Respiratory effects of high thoracic epidural anesthesia. Acta Anaesth-esiol Scand 30: 215-217, 1986 – reference: 2) Taylor A: Contribution of the intercostal muscles to the effort of respiration in man. Journal of Physiology (London) 151: 390-402, 1960 – reference: 11) van Luteren E, Cherniack NS: Electorical and mechanical activity of respiratory muscles during hypercapnea. J Appl Physiol 61: 719-727, 1986 – reference: 1) Campbell EJM, Agostoni E, Newsom-Davis J: The respiratory muscles. In: Mecanics and Neural Con-trol. Philadelphia and London: W.B. Saunders, 1970 – reference: 4) Critchlow V, von Euler C: Rhythmic control of inter-costal muscle spindles. Experimentia 18:426-427, 1962 – reference: 13) Labaille T, Clergue F, Ecoffey C, et al.: Ventilatory response to CO2 following intravenous and epidural lidocaine. Anesthesiology 63: 179-183, 1985 – reference: 10) Read DJC: Aclinical method for assessing the ventilatory response to carbon dioxide. Australian Ann Med 16: 20-32, 1966 – reference: 3) Remmers JE: Inhibition of inspiratory activity by intercostal muscle afferents. Respiration Phisiology 10: 358-383, 1970 – reference: 17) Druz WS, Sharp JT: Activity of respiratory muscles in upright and recumbent humans. J Appl Physiol 51: 1552-1561, 1981 |
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| Title | Effect of High Thoracic Epidural Anesthesia on Ventilatory Response to Hypercapnea in Normal Volunteers |
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