摘要
目的 :观察全麻联合硬膜外阻滞并保留术后镇痛对围术期上腹部手术应激反应和糖代谢的影响。方法 :择期胆囊切除病人 30例 ,随机分为三组 ,每组 10例 ,Ⅰ组全麻联合硬膜外阻滞并保留术后镇痛 ,Ⅱ组硬膜外阻滞保留术后镇痛 ,Ⅲ组硬膜外阻滞不保留术后镇痛。观察围术期血浆生长激素 (GH)、血糖 (BS)和胰岛素 (Ins)浓度变化。结果 :与麻醉前比 ,Ⅰ组术中和术后GH、BS平稳 ,Ⅱ、Ⅲ组术中和术毕即刻BS明显升高 ,但术后 2 4小时Ⅱ组降到正常 ,Ⅲ组BS仍显著升高。术毕即刻Ⅱ、Ⅲ组GH均显著升高 ,术后 2 4小时Ⅱ组GH恢复正常 ,Ⅲ组GH仍持续升高。术后三组Ins均有明显升高。结论
Objective:To evaluate the effect of general anesthesia combined with epidural block and postoperative epidural analgesia on perioperative blood sugar(BS),insulin(Ins)and growth hormone(GH) in patients undergoing upper abdominal.Methods:30 patients undergoing elective cholecystectomy were allocated into 3 groups with 10 cases each.The patients in group Ⅰ received general anesthesia combined with epidural block and postoperative analgesia,and the patients in group Ⅱ received epidural block and postoperative epidural analgesia,the remaining patients in group Ⅲ received epidural analgesia only during surgery.Results:The levels of plasma GH and BS in group Ⅰ were stable during and after operation.The BS in group Ⅱ and Ⅲ was significantly increased during operation and at the end of operation,compared with that before anesthesia.But the levels of BS in group Ⅱ returned to the normal on the first postoperative day.At the end of operation,the concentration of plasma GH in group Ⅱ and Ⅲ was significantly increased in comparison with that before anesthesia,which returned to the normal on the first day after operation in group Ⅱ and was still on the high level until second postoperative day.The concentration of plasma insulin in all 3 groups were significantly increased on the first and second day after operation.Conclusion:The stress response to surgery could be attenuated more effectively by general anesthesia combined with epidural block and postoperative analgesia than by epidural block alone.
出处
《临床麻醉学杂志》
CAS
CSCD
2000年第7期340-342,共3页
Journal of Clinical Anesthesiology
关键词
全麻
硬膜外麻醉
镇痛
上腹部手术
General anesthesia Epidural block Analgesia
Blood glucose Insulin Growth hormone
