高周波熱凝固法による胸部交感神経節ブロックにおける貸借現象に対する前負荷の影響 ： 全身麻酔下雑種成犬における検討

Abstract

Background : Unilateral lumbar sympathectomy involved that increased skin temperature on the ipsilateral foot and simultaneously decreased temperature on contralateral foot. In the neurolyzed extremity, blood flow increased at the expense of contralateral blood flow. The compensatory distribution of blood is called “borrowing-lending” phenomenon (DeBakey. 1947), on which few reported on the account of thoracic sympathetic neurolysis, hence effects of volume preload on the phenomenon were elucidated under radiofrequency neurolysis of thoracic sympathetic ganglion in anesthetized dogs. Method : The 30 dogs were divided into three groups following pre-neurolysis level of right atrial pressure (RA) : 1) hypovolemic group (n=10) : RA<3 mmHg, 2) normovolemic group (n=10) : 3 mmHg≦RA≦6 mmHg, 3) hypervolemic group (n=10) : 6 mmHg<RA. Skin temperature on the bilateral costal arch region and hemodynamic variables were measured before and after neurolysis. Results : No significant changes of hemodynamic variables were observed in all groups. Regional skin temperature of the neurolyzed side increased significantly 5 and 20 minutes after neurolysis. The contralateral skin temperature simultaneously decreased in hypovolemic and normovolemic groups, but we found no change of temperature in hypervolemic group. Conclusion : These results suggest that volume loading plays an important role to antagonize the “borrowing-lending” (Compensatory phenomenon) produced by radiofrequency neurolysis of thoracic sympathetic ganglions.