摘要
硬膜外麻醉是我国普遍采用的一种麻醉方法。一股认为它对手术创伤所致应激反应的抑制效应强于全麻,但临床实践表明,上腹部手术采用硬膜外麻醉尚存在一些缺陷,就应激反应而言,有资料表明硬膜外麻醉状态下,上腹部或下腹部手术对血浆儿茶酚胺、肾素—血管紧张素、cAMP含量无明显影响;但也有资料提示:上腹部手术时采用硬膜外麻醉仍有明显的内分泌激惹现象。
Eighteen Patients were divided into two groups. Group 1 patients who were undergoing upper abdomial operation. Group 2 patients who were undergoing lower abdormial operation. Local anesthetic solution was constituted by 1% lidocaine and 0.165% tetrac aine with adrenaline 1: 200, 000-400, 000. The Plasma cAMP, β-EP (β-endorphin) were measured by radioimmunoassay.
Results show:
1. There were no increase in Plasma cAMP, β-EP levels during induction of epidur al anesthesia.
2. During operation, the concentration of cAMP, or β-EP was still stable in group 2. However, there was a siginificant change in group 1, especially, on one hour after operation.
3. In group 1, cAMP level dropped from 36.8±4.2 to 27.1±1.3 pmo 1/ml(P<0.05) β-EP level decreased from 94.3±8.2 to 81.9±6.5 pg/ml (P<0.05), at 30 min after removal of the diseased organ.
These materials suggested: There is more significant st(?)ess response in upper abdominal procedures than that in lower abdominal, the major nociceptive stimuli of the surgical stres responese might be the taction or dissection of upper abdominal organs.
出处
《临床麻醉学杂志》
CAS
CSCD
北大核心
1990年第4期214-217,共4页
Journal of Clinical Anesthesiology
