J.Jpn. Surg. Soc.. 60(1): 119-130, 1959

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PULMOCIRCULATORY FUNCTION DURING SPINAL ANESTHESIA
RART II. INFLUENCE ON CIRCULATORY FUNCTION

By the catheterization of the right heart the circulatory function during spinal anesthesia was clinically examined and the high level anesthesia was compared to the low level anesthesa. Attention was also paid to the correlation with the respiratory function. The results obtained were as follows :
1. The decreasing tendency of the pulmonary blood flow was more marked in the high level anesthesia than in the low level anesthesia. In the latter the decreasing tendency of the pulmonary blood flow was found even in the cases in whom no remarkable change in blood pressure was observed.
2. Blood pressure, oxygen consumption, and circulation time were all decreased and the arterio-venous difference of oxygen content was increased. These changes were, as was the case with the decrease in the pulmonary blood flow, were more marked in the high level spinal anesthesia. In such cases the increase in oxygen equivalent was also observed.
3. The total peripheral vascular resistance was elevated more markedly in the low level anesthesia than in the high level anesthesia. This was supposed to be ascribed to the compensatory vasoconstriction of the unanesthetized regions.
4. The findings stated above were useful in the clarification of the shock during the spinal anesthesia when comparison was made to the patho-physiology in C₆ hypotension.
5. By pressor agents the arterio-venous difference of oxygen content was decreased, the circulation time, pulmonary blood flow, oxygen consumption, total peripheral vascular resistance approached the physiological levels, and the influence on the respiratory phase was also improved.
6. When anoxia was present due to a marked decrease in pulmonary ventilation, a tendency of the increase in pulmonary blood flow was observed and the mutual compensation between respiration and circulation were apparent.
7. From the examination of the patho-physiology of the lowered blood pressure during spinal anesthesia, it was clear that pressor drugs and oxygen were valuable in its treatment.
(author's abstract)

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