Брадикардiя пiд час спiнальної анестезiї

Автор(и)

  • В. С. Фесенко Харкiвська медична академiя пiслядипломної освiти, Харкiв, Україна

DOI:

https://doi.org/10.25284/2519-2078.2(67).2014.84973

Ключові слова:

спiнальна анестезiя, ускладнення, брадикардiя

Анотація

Поширенiсть брадикардiї пiд час спiнальної анестезiї – доволi висока (вiд 5 до 13%), тяжка брадикардiя (частота серцевих скорочень менш нiж 40 на хвилину) трапляється рiдше (0,7%). Головний механiзм – «зворотний» рефлекс Бейнбриджа внаслiдок зниженого венозного припливу до правого передсердя. Iншi причиннi фактори: чоловiча стать, частота серцевих скорочень менш нiж 60 на хвилину, вiк молодше за 37 рокiв, тривала операцiя, подовжений iнтервал PQ. Лiкування: атропiн (0,4–1,0 мг), ефедрин (25–50 мг), адреналiн (0,2–0,3 мг). Профiлактика – пiдтримання венозного припливу пiд час i пiсля операцiї. Глибока брадикардiя може призвести до зупинки серця, що потребує торакального масажу.

Біографія автора

В. С. Фесенко, Харкiвська медична академiя пiслядипломної освiти, Харкiв

Фесенко В.С.

Посилання

Малрой М. (2003) Местная анестезия: Иллюстрированное практическое руководство. Пер. с англ. М.: БИНОМ. Лаборатория знаний, 301 с.

Caplan R.A., Ward R.J., Posner K., Cheney F.W. (1988) Unexpected cardiac arrest during spinal anesthesia: a closed claims analysis of predisposing factors. Anesthesiology; 68, 1: 5-11. https://doi.org/10.1097/00000542-198801000-00003

Ponhold H., Vicenzi M.N. (1998) Incidence of bradycardia during recovery from spinal anaesthesia: influence of patient position. Br. J. Anaesth; 81, 5: 723-726. https://doi.org/10.1093/bja/81.5.723

Wenk M., Weiss C., Möllmann M., Pöpping D. M. (2012) Procedural complications of spinal anaesthesia in the obese patient. Anesthesiol. Res. Pract: 165267. https://doi.org/10.1155/2012/165267

Kyokong O., Charuluxananan S., Sriprajittichai P., et al. (2006) The incidence and risk factors of hypotension and bradycardia associated with spinal anesthesia. J Med Assoc Thai; 89, suppl 3: S58-S64.

Tarkkila P., Kaukinen S. (1991) Complications during spinal anesthesia: a prospective study. Reg. Anesth;16, 2:101-106.

Carpenter R. L., Caplan R.A., Brown D.L., et al. (1992) Incidence and risk factors for side effects of spinal anesthesia. Anesthesiology; 76,6:906-916. https://doi.org/10.1097/00000542-199206000-00006

Lesser J.B., Sanborn K.V., Valskys R., Kuroda M. (2003) Severe bradycardia during spinal and epidural anesthesia recorded by an anesthesia information management system. Anesthesiology;99, 4:859-866. https://doi.org/10.1097/00000542-200310000-00018

Campagna J.A., Carter C. (2003) Clinical relevance of the Bezold-Jarisch reflex. Anesthesiology;98, 5:1250-1260. https://doi.org/10.1097/00000542-200305000-00030

Crystal G.J., Salem M.R. (2012) The Bainbridge and the “reverse” Bainbridge reflexes: history, physiology, and clinical relevance. Anesth. Analg.;114, 3:520-532. https://doi.org/10.1213/ane.0b013e3182312e21

Greene N.M. (1958) Physiology of Spinal Anesthesia. Baltimore: Williams and Wilkins.

Brooker R.F., Butterworth J.F., Kitzman D.W., et al. (1997) Treatment of hypotension after hyperbaric tetracaine spinal anesthesia. Arandomized, double-blind, cross-over comparison of phenylephrine and epinephrine. Anesthesiology; 86, 4:797-805. https://doi.org/10.1097/00000542-199704000-00009

O’Rourke G.W., Greene N.M. (1970) Autonomic blockade and the resting heart rate in man. Am. Heart J;.80,4:469-474. https://doi.org/10.1016/0002-8703(70)90193-6

Baron J.F., Decaux-Jacolot A., Edouard A., et al. (1986) Influence of venous return on baroreflex control of heart rate during lumbar epidural anesthesia in humans. Anesthesiology; 64,2:188-193. https://doi.org/10.1097/00000542-198602000-00010

Chang K.S., Morrow D.R., Kuzume K., Andresen M.C. (2000) Bupivacaine inhibits baroreflex control of heart rate in conscious rats. Anesthesiology; 92, 1:197-207. https://doi.org/10.1097/00000542-200001000-00032

Bonica J.J., Kennedy W.F., Akamatsu T.J., Gerbershagen H.U. (1972) Circulatory effects of peridural block: 3. Effects of acute blood loss. Anesthesiology;36, 3:219-227. https://doi.org/10.1097/00000542-197203000-00006

Ecoffey C., Edouard A., Prushczynski W., Taly E., Samii K. (1985) Effects of epidural anesthesia on catecholamines, renin activity, and vasopressin changes induced by tilt in elderly men. Anesthesiology;62, 3:294-297. https://doi.org/10.1097/00000542-198503000-00014

Limongi J.A., Lins R.S. (2011) Cardiopulmonary arrest in spinal anesthesia. Rev. Bras. Anestesiol;61, 1:110-120. https://doi.org/10.1016/s0034-7094(11)70012-5

Liguori G.A., Kahn R.L., Gordon J., et al. (1998) The use of metoprolol and glycopyrrolate to prevent hypotensive/bradycardic events during shoulder arthroscopy in the sitting position under interscalene block. Anesth. Analg;87, 6:1320-1325. https://doi.org/10.1213/00000539-199812000-00020

Hampl K.F., Schneider M.C. (1994) Vasovagal asystole before induction of general anaes thesia. Eur. J. Anaesth;11, 2:131-133.

Paul G.E., Carpenter R.L., Stephenson C., Wu R. (1993) Prolonged PR interval associated with increased incidence of bradycardia during spinal anesthesia. Anesthesiology;79: A1086.

Kaimar P., Sanji N., Upadya M., Mohammed K.R. (2012) A comparison of hypotension and bradycardia following spinal anesthesia in patients on calcium channel blockers and β-blockers. Indian J. Pharmacol.;44, 2:193-196. https://doi.org/10.4103/0253-7613.93847

Pontén J., Biber B., Bjurö T., et al. (1982) Beta-receptor blockade and spinal anaesthesia. Withdrawal versus continuation of long-term therapy. Acta Anaesthesiol. Scand. Suppl;76:62-69.

Berry W.R. (2012) Cardiac resuscitation in the operating room: reflections on how we can do better. Can. J. Anaesth;59, 6:522-526. https://doi.org/10.1007/s12630-012-9697-5

Moitra V.K., Gabrielli A., Maccioli G.A., O’Connor M.F. (2012) Anesthesia advanced circulatory life support. Can. J. Anaesth;59, 6:586-603. https://doi.org/10.1007/s12630-012-9699-3

Pollard J.B. (2001) Cardiac arrest during spinal anesthesia: common mechanisms and strategies for prevention. Anesth. Analg;92, 1:252-256. https://doi.org/10.1097/00000539-200101000-00050

Brown D.L., Carpenter R.L., Moore D.C., et al. (1988) Cardiac arrest during spinal anesthesia. III [letter]. Anesthesiology;68, 6:971-972. https://doi.org/10.1097/00000542-198806000-00040

Chamchad D., Horrow J.C., Nakhamchik L., et al. (2011) Prophylactic glycopyrrolate prevents bradycardia after spinal anesthesia for Cesarean section: a randomized, double-blinded, placebo-controlled prospective trial with heart rate variability correlation. J. Clin. Anesth;.23, 5:361-366. https://doi.org/10.1016/j.jclinane.2010.12.008

Barreiro G., van Zundert A., Al-Shaikh B. (2006) Unexpected cardiac arrest in spinal anaesthesia. Acta Anaesthesiol. Belg;57, 4:365-370.

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Опубліковано

2014-07-21

Як цитувати

Фесенко, В. С. (2014). Брадикардiя пiд час спiнальної анестезiї. PAIN, ANAESTHESIA & INTENSIVE CARE, (2(67), 30–36. https://doi.org/10.25284/2519-2078.2(67).2014.84973

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