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KMID : 0350519960490010331
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Journal of Catholic Medical College
1996 Volume.49 No. 1 p.331 ~ p.339
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Comparison of hemodynamics and Estimated Hepatic Blood Flow between General Anesthesia and High Thoracic Epidural Anesthesia in Rabbits
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Abstract
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Hepatic dysfunction may occur after single or repeated exposures to the halogenated inhaled anesthetics. The caused of hepatic dysfunction may be free radical, metabolites of inhaled anesthetics, immune reaction, and hypoxic damage by decreasing
total
blood flow.
The majority of anesthetics decrease portal blood flow associated with a decrease in cardiac output. The increase in hepatic blood flow, when it occurs, is usually not enough to compensate for the decrease in portal blood flow. Therefore total
hepatic
blood flow decreases during anesthesia. Hepatic circulatory disturbances with a subsequent decrase in hepatic oxygen supply play an important role in the multifacotorial etiology to periperative liver injury.
The present study was performed with comparison of estimated hepatic blood flow and systemic hemodynamic changes between the general anesthesia and the thoracic epidular anesthesia in rabbits.
Twenty healthy rabbits, weighing 2.5-3.5kg, were divided into two groups. In general anesthesia group, anesthesia with enflurane 2 vol % and 100% O2 lasted for 60 minutes. In thoracic epidural anesthesia group, epidural block was done at T5 level
with
0.4ml/kg of 1% lidocaine. Hepatic blood flow was estimated by clearance of indocyanine green according to the constant infusion method.
Blood was simultaneously withdrawn from the hepatic vein and femoral artery for the measurement of hepatic blood flow before and 30, 60 minutes after anesthesia. Heart rate, mean arterial pressure, central Venous pressure were also measured at
the
same
time in both groups.
@ES The results were as follows;
@EN 1. Heart rates decreased significantly to 12, 14% at 30, 60 minutes in thoracic epidural anesthesia group (P<0.05).
2. Mean arterial pressures decreased significantly o o 27, 21 % at 30, 60 minutes in general anesthesia group, whereas the decreases were 18, 14% at 30, 60 minutes in thoracic epidural anesthesia group (P<0.05). There was significant
difference
in
mean arterial pressure between the general anesthesia group and the thoracic epidural anesthesia group (P<0.05).
3. Central venous pressure decreased 10% at 30, 60 minutes in general anesthesia group and in thoracic epidural anesthesia group the decrease of 14, 13% at 30, 60 minutes was observed (P<0.05).
4. Estimated hepatic blood flows decreased to 30, 23% at 30, 60 minutes in general anesthesia group (P<0.05), whereas the decreases were 28.24% in thoracic epiduual anesthesia group (P<0.05). There was no significant difference between the
general
anesthesia group and the thoracic epidural anesthesia group.
5. Splanchnic vascular resistances increased significantly to 14, 13% at 30, 60 minutes I thoracic epidural anesthesia group (P<0.05).
There was significant difference between the general anesthesia group and the thoracic epidural anesthesia group (P<0.05).
We consider that the decrease of hepatic blood flow was associated with the decrease of mean arterial prossure in the general anesthesia group and the decrease of hepatic blood flow resulted from the increase of splanchnic vascular resistance in
case of
the thoracic epidural anesthesia group.
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