摘要
目的观察硬膜外阻滞和辅助静脉内麻醉行胆囊切除术老年患者血浆内皮素(ET)和一氧化氮(NO)的变化。方法43例择期胆囊切除术患者,随机分为两组:1组静注异丙酚和芬太尼;2组静注哌替啶和异丙嗪。分别于麻醉前、麻醉后、分离/牵拉胆囊及术毕取静脉血测定ET和NO含量和监测心率(HR)、血压(BP)、氧饱和度(SpO2)。结果麻醉后两组BP和ET均明显下降,NO升高;分离/牵拉胆囊时HR、BP、NO下降,ET上升;术毕恢复到麻醉前水平。结论硬膜外麻醉后、分离/牵拉胆囊时BP下降与神经和体液因素调节均有关;小剂量异丙酚和芬太尼能有效减轻应激反应,推荐用于全麻-硬膜外复合麻醉。
Objective To observe the changes of endothelin（ET） and nitric oxide （NO） of old patients undergoing cholecystectomy epidural anesthesia combining with intravenous anesthesia. Methods Fourty-three patients undergoing cholecystectomy were randomly divided into two groups . propofol fentanyl intravenous anesthesia group （group Ⅰ）,and pethidine propofol intravenous anesthesia group （group Ⅱ）. The content of NO and ET were tested, HR, BP and SpO2 were monitered before and after anesthesia, when stretching vesica biliaris,and after operation respectively. Results BP and ET of two grougs significantly declined and NO increased after anesthesia; HR,BP and NO declined and ET increased when separating or stretching vesica biliaris;All the values restored to the level before anesthesia after operation. Conclusion The BP declining after epidural anesthesia or when separating / stretching vesica biliaris were all related with the adjusting of nerve and body liquid. And little propofol and fentanyl can effectively relieve stress response. So it is recommended that general anesthesia combining with epidural anesthesia is fit for cholecystectomy.
出处
《重庆医学》
CAS
CSCD
2006年第2期147-148,151,共3页
Chongqing medicine
