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Plethysmographic changes during epidural anesthesia

Plethysmographic changes during epidural anesthesia

Masui. Japanese Journal of Anesthesiology 37(3): 334-339

Relationship between changes in the amplitude of continuously recorded plethysmograph of both fingers and toes and the level of epidural anesthesia were studied in 50 patients. When analgesia is produced on the upper limb (T2-T8) or on the lower limb (T10-L2) sympathetic area, the amplitude of the plethysmograph at the upper and lower limbs increased. In the cases where segmental height of blockade spread to T7 or above, two patterns were seen. In the first pattern, the amplitudes of both finger and toe plethysmograph increased. In the other pattern, only the amplitude of toe plethysmograph increased. These differences probably arise because the degree of compensatory sympathetic stimulation on the unanesthetized area is different. In the cases where the amplitude of both finger and toe plethysmograph increased, the time from the point of injection to the point where the amplitude of plethysmograph increased depended on the site of injection. The time differences between finger and toe, and the point of injection showed a linear relationship. When the amplitude of plethysmograph showed no change, the epidural block failed. In a patient who had severe hypotension (60/40), flat plthysmograph (60/40), flat plethysmograph was observed at the begining. These results indicate that simultaneous recordings of both finger and toe plethysmographs are useful for evaluating the level of epidural analgesia and for monitoring circulatory condition.

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Accession: 006135819

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PMID: 3398211

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