摘要
目的 :探讨降钙素基因相关肽和内皮素是否在抑制气管插管引起的应激反应方面参与了调节作用及麻醉前应用可乐定对其可能发生的影响。方法 :气管插管全麻下手术 2 0例 ,随机分为对照组 (C组 )和可乐定组 (K组 )。除 K组于麻醉前 6 0 min加服可乐定 5 μg/ kg外 ,两组患者其他麻醉前用药和诱导插管方法相同。分别在麻醉前、插管后 1min、5 min、10 min测定血浆中 CGRP、ET、血糖、血乳酸浓度并记录各时点的血流动力学参数。结果 :与麻醉前比较 ,C组血浆 CGRP在气管插管期间有降低趋势 ,但差别无显著性 ,K组血浆 CGRP在气管插管期间有升高趋势 ,但差别无显著性 ,两组比较 P>0 .0 5 ;两组血浆 ET在气管插管后 1min及 C组在 5、10 min比麻醉前升高 ,与麻醉前比较 P>0 .0 5 ,两组比较 P>0 .0 5。与麻醉前值比较 ,两组插管后 1min血糖、血乳酸浓度及 C组插管后 5 min血乳酸均明显增高 (P<0 .0 5或 P<0 .0 1) ;两组比较 :在拔管后 1min和 5 min,K组血糖和血乳酸均低于 C组 ,其中在插管后 1min血糖升高程度明显低于 C组 (P<0 .0 5 )。与麻醉前值比较 ,C组插管后 1、5 min及 K组插管后 1min血压、心率及 RPP有较明显升高 (P<0 .0 5或 P<0 .0 1) ;两组比较 ,RPP变化 K组明显低于 C组 (P<0 .0 1)。结论 :麻醉前应用?
Objective:To investigate the effect of premedication with clonidine on the concentrations of calcitonin gene-related peptide (CGRP) and endothelin (ET) and carbohydrate metabolism during tracheal intubation.Method:Twenty patients scheduled for general anesthesia with tracheal intubation were randomly divided into control group (n=10) and clonidine group (n=10).Oral premedication with clonidine 5 μg/kg was taken in clonidine group 60 min before anesthesia induction in addition to common anesthesia in two groups;The change of hemodynamics ,arterial plasma concentration of CGRP and ET、 blood sugar, lactic acid were measured before anesthesia,and 1, 5,10 min after tracheal intubation respectively .Result:There were not significant differences in the levels of CGRP and ET after tracheal intubation ,but there was sifnificant differences in blood sugar,lactic acid level at 1 min after tracheal intubation in two groups ,and lactic acid,at 5 min in control group (P<0.05 or P<0.01). and the sugar level at 1 min after tracheal intubation in control group was sifnificantly higher than that in clonidine group (P<0.05). The change of hemodynamics was more stable in clonidine group than in control group.Conclusion:Oral premedication with clonidine could attenuate stress response during tracheal intubation ,but CGRP was not involved in this regulatory action.
出处
《中国误诊学杂志》
CAS
2004年第8期1201-1203,共3页
Chinese Journal of Misdiagnostics
