[Hemodynamic and respiratory changes in cervical peridural anesthesia].

Abstract

Regional anesthesia as a method of avoiding stress and preserving the immunological system has found a solid place in the armamentarium of anesthesia departments. Its applicability for anesthesia of higher segments is controversial. In order to test the reliability of this method, at 7 perioperative measuring points we studied respiratory and circulatory parameters of 17 patients undergoing breast surgery. Access to the peridural space was via C6/7 or C7/T1 by catheterization with the hanging-drop method. The respiratory and circulatory parameters were determined by direct measurement of arterial and pulmonary-arterial pressures and by arterial and mixed-venous blood samples. The main criterion was determination of the arterio-venous oxygen difference. It was shown that the cardiovascular and respiratory integrity of the organism remained unaffected. The most marked changes in relation to the starting point were seen at measuring point 5 (40 min after beginning anesthesia): heart rate -22.4% (p less than 0.05), mean arterial pressure -35.1% (p less than 0.05), mean pulmonary-arterial pressure + 18.1% (NS), mixed-venous oxygenation -5.5% (NS), arteriovenous oxygen difference +25.9% (NS) arterial pO2 -4.4% (NS) and pCO2 +7.9% (p less than 0.05). --In the hands of an anesthetist fully acquainted with conduction anesthesia, cervical peridural anesthesia for appropriate indications may be proposed as an alternative anesthesiological method.