87532
document
[ Intraoperative continuous epidural block influences postoperative changes in breathing pattern and thoracoabdominal movement associated with upper abdominal surgery ] . We have examined the changes in breathing pattern and thoracoabdominal movement associated with upper abdominal surgery in order to evaluate the possible influences of nociceptive input on respiration . Sixteen patients scheduled for gastrectomy were studied . Continuous epidural block was instituted prior to the induction of anesthesia and maintained throughout the surgery in 8 of 16 patients ( Group 1 ) while it was instituted upon the peritoneal closure and maintained thereafter in the remaining 8 patients ( Group 2 ) . Breathing pattern and thoracoabdominal motion were determined before and after surgery while the patients awake by respiratory inductance plethysmography ( Respisomnography , Chest MI ) . Breathing frequency and minute ventilation increased significantly while tidal volume was unchanged after the operation regardless of the intraoperative epidural block . Furthermore , there were identical shortening of inspiratory time and prolongation of duty ratio ( inspiratory time/duration of a breath ) in the two groups . Contribution of rib cage movement on tidal volume increased significantly postoperatively in all the patients . However , the changes were significantly smaller in patients receiving intraoperative epidural block . These results indicate that the causes of tachypnea and increased minute ventilation are different from the mechanism responsible for the alteration of thoracoabdominal partitioning of ventilation after upper abdominal surgery . The former may be related to the metabolic changes and , conceivably , unaffected by continuous epidural block . While the latter may be the consequence of the reflex inhibition of the diaphragmatic function that can be , at least partially , modified by continuous epidural block .
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Intervention_Physical
Continuous
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Intervention_Pharmacological
epidural block
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Intervention_Physical
surgery
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Intervention_Physical
respiratory inductance plethysmography ( Respisomnography , Chest MI )
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Outcome_Physical
Breathing pattern and thoracoabdominal motion
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Outcome_Physical
Breathing frequency and minute ventilation
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Outcome_Physical
inspiratory time and prolongation of duty ratio
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Outcome_Physical
Contribution of rib cage movement on tidal volume
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Participant_Sample-size
Sixteen
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Participant_Condition
scheduled for gastrectomy