摘要
目的研究全麻合并胸段硬膜外阻滞对兔机械性心肌梗死的应激性损伤的影响。方法 实验组兔 (n =9)于气管切开插管全麻合并胸段硬膜外阻滞 (TEA)下开胸结扎左冠状动脉前降支 ,在结扎前、结扎 15、30、6 0、12 0、180、2 40min于颈总动脉取血 ,用高压液相色谱法测血浆单胺类神经递质、放射免疫分析法测兔血浆皮质醇、血管紧张素Ⅱ。取非梗死心肌做肿瘤坏死因子(TNFα)的免疫组织化学分析。对照组 (n =9)不作TEA ,其余处理与实验组相同。结果 血浆NE、5 HT水平在冠状动脉结扎前两组无显著性差异 ,NE在 30min时实验组无显著性变化 (P >0 0 5 ) ,而对照组则显著性升高 (P <0 0 5 ) ;4h后对照组NE、5 HT的浓度比实验组明显升高 (P <0 0 5 )。兔正常心肌内的TNFα的免疫组化着色结果表现为实验组灰度比对照组有显著降低 (P <0 0 5 )。结论 气管插管全麻合并胸段硬膜外阻滞比单纯气管插管全麻能降低机械性心肌梗死的应激水平 ,对应激性损伤有明确的保护作用。
Objective To research the stress to experimental myocardial infarction under general anesthesia combined with thoracic epidural anesthesia(TEA) Methods Nine rabbits in experimental group were anesthetized with 1% sodium pentobarbitone with tracheal intubation after sectioned, and after the epidural catheters was put into to make sure that the epidural anesthesia was effective, the anterior descending branches of their left coronary artery were ligated All procedures in control group were similar to those of experimental group except for thoracic epidural anesthesia The blood samples from left common carotid artery before ligation were taken 15,30,60,120,180 and 240min after ligation, to measure the plasma levels of monoamine neurotransmitters with high performence liquid chromatography, the Ag Ⅱ and cortisol levels with radioimmunoassay TNFa content in non infarction myocardium was assessed with immunohistochemistry Results There were no differences in NE and 5 HT levels between both groups before ligation Thirty min after the ligation, NE level in experimental group remained unchanged, but in control group increased markedly(P<0 05) 4h after the ligation, NE and 5 HT levels were obviously higher in control group than those in experimental group(P<0 05) The grey value of myocardial TNFα in experimental group was lower than that in control group(P<0 05) Conclusion As compared with general anesthesia, general anesthesia combined with TEA can reduce the stress level of rabbits with experimental myocardial infarction
出处
《中华麻醉学杂志》
CAS
CSCD
北大核心
2000年第11期684-686,共3页
Chinese Journal of Anesthesiology
基金
国家教委博士点基金资助!基金号 9743
关键词
全身麻醉
硬膜外麻醉
心肌梗塞
应激反应
Anesthesia,general
Anesthesia, epidural
Myocardial infarction
Stress
