Systemic and Regional Blood-flow Changes during Spinal Anesthesia in the Rhesus Monkey

Sivarajan, Murali; Amory, David W.; Lindbloom, Leo E.; Schwettmann, Rick S.

doi:10.1097/00000542-197507000-00017

Cited by 39 publications

(6 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…(23) The use of low spinal anesthesia has been shown not to affect regional blood ow to the heart. (24) On the other hand, the densely innervated by sympathetic nerve bers epicardial coronary arteries(25) could be affected by sympathectomy leading to vasodilation. This could produce an effect similar to classic cardiac vasodilators such as nitroderivatives or adenosine,(26) , ( 27) , (28) leading to increased diameter of stenotic coronary arteries thus providing optimized coronary blood ow to hibernating myocardial regions, as has been hypothesized for thoracic epidural anesthesia (TEA).…”

Section: Discussionmentioning

confidence: 99%

The Impact of Spinal Anesthesia on Cardiac Function in Euvolemic Vascular Surgery Patients: Insights from Echocardiography and Biomarkers

Gkoudi,

Loutradis,

Tzimou

et al. 2024

Preprint

View full text Add to dashboard Cite

Objectives: Existing evidence of the effect of spinal anesthesia on cardiac systolic function is scarce and inconclusive. This study aimed to evaluate the effects induced by a single injection of low-dose SA for elective vascular surgery on left (LV) and right (RV) ventricular systolic performance using transthoracic echocardiography (TTE). Design: A prospective study Setting: Single-center study, university hospital Participants: Adult patients undergoing elective vascular surgery with SA. Interventions: During patients’ evaluations fluid administration was targeted using arterial waveform monitoring. All patients underwent TTE studies before and after SA for the assessment of indices reflective of LV and RV systolic function. Blood samples were drawn to measure troponin and brain natriuretic peptide (BNP) levels. Measurements and Main Results: A total of 62 patients (88.7% males, 71.00±9.42 years) were included in the study. In total population, LV ejection fraction (LVEF) significantly increased after SA 53.07% [16.51]vs 53.86% [13.28]; p<0.001). End-systolic volume (ESV, 69.50 [51.50] vs 65.00 [29.50] ml; p<0.001) decreased while SV insignificantly increased (70.51±16.70 vs 73.00±18.76 ml; p=0.131) during SA. Tricuspid annular plane systolic excursion (TAPSE) remained unchanged (2.23 [0.56] vs 2.25 [0.69] mm; p=0.558). In patients with impaired compared to those with preserved LV systolic function, the changes evidenced in LVEF (7.49±4.15 vs 0.59±2.79; p<0.001), ESV (-18.13±18.20 vs-1.53±9.09; p<0.001) and SV (8.71±11.96 vs-1.43±11.89; p=0.002) were greater. Conclusions: This study provides evidence that SA in euvolemic patients undergoing elective vascular surgery improved LV systolic function, while changes in RV systolic function are minimal.

show abstract

Section: Discussionmentioning

confidence: 99%

The Impact of Spinal Anesthesia on Cardiac Function in Euvolemic Vascular Surgery Patients: Insights from Echocardiography and Biomarkers

Gkoudi,

Loutradis,

Tzimou

et al. 2024

Preprint

View full text Add to dashboard Cite

show abstract

“…The latter might be relevant to the fluid balance during anesthesia 15 although animal studies provide conflicting evidence 16 . By contrast, arterio‐venous shunting in the legs increases during spinal anesthesia 17 and should reduce the endothelial surface available for filtration. Shedding of the endothelial glycocalyx layer might alter the capillary permeability, but the role of this process in the distribution of crystalloid fluid is unclear at present 18 …”

Section: Discussionmentioning

confidence: 99%

Model‐predicted capillary leakage in graded hypotension: Extended analysis of experimental spinal anesthesia

Hahn

Drobin

2021

Acta Anaesthesiol Scand

View full text Add to dashboard Cite

Background Crystalloid fluid infused during the induction of spinal anesthesia is involved in a complex set of physiological responses, including vasodilatation, reactive vasoconstriction, and changes in mean arterial pressure (MAP). The present evaluation compares the modeled capillary leakage in anesthetized versus nonanesthetized body regions. Methods Ten female volunteers (mean age, 29 years) received 25 ml/kg of Ringer's acetate over 60 min during experimental spinal anesthesia. Blood hemoglobin was measured repeatedly in the radial artery (reference), arm (cubital) vein, and leg (femoral) vein for 240 min. Each pattern of data served as a dependent variable in volume kinetic analyses that used mixed models software and MAP as covariate. Results The capillary leakage of fluid from the plasma to the extravascular space peaked at 17 ml/min when MAP was 100 mmHg, and the two venous curves were virtually identical. At MAP 60 mmHg, the rate was reduced to 10‐12 ml/min when assessed in arterial blood and leg vein blood, but only 5 mmHg in blood collected from the arm vein. The distribution half‐life of infused fluid was then 40 min in the leg and 80 min in the arm. These results suggest that vasoconstriction in nonanesthetized body regions halves the capillary leakage that is observed in vasodilated, anesthetized body regions. Conclusion Graded hypotension during spinal anesthesia reduced the capillary filtration of fluid as determined by volume kinetic analysis. The effect was twice as great when venous blood was sampled from a nonanesthetized body region than from an anesthetized body region.

show abstract

“…Lumbar epidural anesthesia has been associated with a transient elevation in intracranial pressure in animals, which could result in decreased cerebral blood flow because the craniospinal space cannot expand. 27,28 However, in human subjects, neuraxial anesthesia does not appear to cause increased intracranial pressure. 29 This study has some limitations, which merit further discussion.…”

Section: Discussionmentioning

confidence: 99%

The Effect of Neuraxial Anesthesia on Maternal Cerebral Hemodynamics

et al. 2013

View full text Add to dashboard Cite

show abstract

Systemic and Regional Blood-flow Changes during Spinal Anesthesia in the Rhesus Monkey

Cited by 39 publications

References 0 publications

The Impact of Spinal Anesthesia on Cardiac Function in Euvolemic Vascular Surgery Patients: Insights from Echocardiography and Biomarkers

The Impact of Spinal Anesthesia on Cardiac Function in Euvolemic Vascular Surgery Patients: Insights from Echocardiography and Biomarkers

Model‐predicted capillary leakage in graded hypotension: Extended analysis of experimental spinal anesthesia

The Effect of Neuraxial Anesthesia on Maternal Cerebral Hemodynamics

Contact Info

Product

Resources

About