[The effectiveness of cervical epidural block for the treatment of status asthmaticus]

Epidural anesthesia is currently used for the operation of patients who have bronchial asthma. We have ascertained the effectiveness of cervical epidural block for the treatment of status asthmaticus even in the ICU. The present patient had repeated history of severe asthma and was no longer expected to respond to the routine therapy. After we failed to wean him from the ventilator several times, we performed cervical epidural block on him. His condition improved dramatically after the block and he was easily weaned from the ventilator. The three notable improvements are (1) no use of sedatives, (2) normalized arterial blood pH with decrease in expiratory resistance and (3) stabilization of circulation. Sympathetic nervous system is excited in patients with asthmatic attack. As a result, high concentrations of catecholamines deteriorate general condition of patients. On the other hand, cervical epidural block seems to be effective to prevent hyperactive sympathetic nervous system. Our result suggests that alpha-adrenergic effect of epinephrine which is given as a routine therapeutic drug, will very likely worsen asthmatic attack.