Mass spectrometric measurements of oxygen uptake during epidural analgesia combined with general anesthesia.
Oxygen uptake was measured using a mass spectrometer system in 12 patients scheduled for abdominal surgery who intraoperatively were mechanically ventilated with 50% nitrous oxide and given continuous intravenous infusions of methohexital (3.5 mg.kg-1.h-1) plus repeated epidural injections of lidocaine. At the end of the surgical procedure, meperidine (0.7 mg/kg) was epidurally injected in six patients (group A). The other six patients (group B) received no epidural injections during the first 2 h after surgery. Intraoperatively, oxygen uptake decreased in both groups by an average of 28%. Within the first two postoperative hours, clear-cut differences among the two groups arose. Patients in group A had smoother increases in oxygen uptake and core temperatures, greater cardiovascular stability as reflected by the rate-pressure product, and no visible shivering. We suggest that epidural meperidine given immediately at the end of a surgical procedure might be beneficial, especially, perhaps, in patients with impaired cardiac function.
Viale
J P
JP
Département d'Anesthésie-Réanimation, Hospices Civils de Lyon, Hôpital Edouard Herriot, France.
Annat
G J
GJ
Tissot
S M
SM
Hoen
J P
JP
Butin
E M
EM
Bertrand
O J
OJ
Motin
J P
JP
D000005:Abdomen / Q000601:surgery; D000328:Adult; D000368:Aged; D015360:Analgesia, Epidural; D000767:Anesthesia, Epidural; D000768:Anesthesia, General; D006801:Humans; D007262:Infusions, Intravenous; D007268:Injections, Epidural; D007432:Intraoperative Period; D013058:Mass Spectrometry; D008614:Meperidine / Q000008:administration & dosage / Q000627:therapeutic use; D008723:Methohexital; D008875:Middle Aged; D010100:Oxygen / Q000032:analysis; D010101:Oxygen Consumption; D010149:Postoperative Pain / Q000188:drug therapy; D011659:Pulmonary Gas Exchange; D012121:Respiration, Artificial
D008614:Meperidine; D008723:Methohexital; D010100:Oxygen