摘要
目的 观察术后硬膜外自控镇痛 (PCEA)对血浆神经肽Y(NPY)水平的影响。方法 5 8例胸外科手术病人随机分为PCEA组 (2 8例 )和对照组 (30例 )。PCEA组病人手术后采用硬膜外自控镇痛 ,维持视觉模拟评分 (VAS) <3分 ,对照组根据需要间断肌注哌替啶。采用放射免疫法测定麻醉前、手术结束、术后 2 4h和 48h血浆NPY和血清皮质醇浓度。结果 两组病人手术结束时血浆NPY及血清皮质醇浓度均较麻醉前明显升高 ,组间无差异。血浆NPY浓度PCEA组术后 2 4h恢复到麻醉前水平 ;对照组术后 2 4h开始下降 ,但仍明显高于麻醉前和同时期PCEA组水平 ,术后 48h恢复到麻醉前水平。血清皮质醇浓度PCEA组术后 2 4h开始下降 ,术后 48h恢复到麻醉前水平 ;对照组术后 2 4h和 48h虽呈下降趋势 ,但仍明显高于麻醉前及同时期PCEA组水平。
Objective To observe the effects of postoperative patient controlled epidural analgesia(PCEA) on plasma neuropeptide Y(NPY) Methods Fifty eight patients scheduled for thoracic surgery, were randomly divided into PCEA group(n=28) and control group(n=30) After operation, patient controlled epidural analgesia was applied in PCEA group and in control group pethidine I M was given intermittently The plasma NPY and serum cortisol concentrations were measured at pre anesthesia,the end of operation,and 24h and 48h after operation by radioimmunossay Results Compared with the baselines, plasma NPY and serum cortisol levels increased significantly at the end of operation in both groups ,without the obvious differences between both groups The plasma NPY level restored to the baseline in PCEA group 24h after operation, and in control group was significantly higher 24h after operation than the besaline and restored to the besaline 48h after operation The serum cortisol level was kept higher level 24h after operation and restored to the baseline 48h after operation in PCEA group, and in control group increased significantly 24h and 48h after operation as compared with the baseline The plasma NPY level 24h after operation and serum cortisol level 24h and 48h after operation were lower markedly in PCEA group than those in control group Conclusions The PCEA can effectively depress the increase of plasma NPY and serum cortisol induced by postoperative pain in patients undergoing thoracic surgery
出处
《中华麻醉学杂志》
CAS
CSCD
北大核心
2000年第8期503-505,共3页
Chinese Journal of Anesthesiology
关键词
镇痛
手术后疼痛
神经肽Y
术后硬膜外自控镇痛
Analgesia,epidural
Analgesia,patient controlled
Pain,postoperative
Neuropeptide Y
