摘要
１６例择期手术病人随机分成硬膜外阻滞（ＥＢ）组和静脉普鲁卡因复合麻醉（ＩＰＢＡ）组。血浆去甲肾上腺素（ＮＥ）含量的测定采用高效液相电化学法。结果：麻醉前５ｍｉｎ和切皮前５ｍｉｎＥＢ组的ＮＥ水平均显著高于ＩＰＢＡｆｆｉ（Ｐ＜０．０１），说明硬膜外穿刺和病人对手术的焦虑与ＮＥ水平的升高有关。切皮后６０ｍｉｎ，两组ＮＥ水平均升高至最高点，约为各自麻醉前值的２倍（Ｐ＜０．０１），提示两种方法均不能有效地防止手术应激的发生。术后６０ｍｉｎ，两组ＮＥ值均比各自术中值明显下降了４０～５０％（ｐ＜０．０１），提示手术刺激是上腹部手术病人应激反应的主要启动因素。
ixteen patients undergoing upper abdominal surgery were randomly divided into two groups,epidural block(EB)and intravenous procaine balanced anesthesia(IPBA).Plasma norepinephrine(NE)was measured by HPLC.It was found that NE Ievels at 5min before anesthesia and 5 min before skin incision were significantly higher in EBgroup than those in IPBA group(both,p<0.01)indicating that epidural puncture and patient’s anxiety are respon-sible for an increase in NE in EB patients. Plasma NE concentration at 60 min after incision was almost doubledcompared with that before anesthesia in both groups(both,p<0.01)suggesting that neither EB nor IPBA can pro-tect the patient from surgical stress.NE level was decreased by 40-50%at 60 min after operation in both groups(both;p<0.01).It is concluded tha:surgical procedure is the main factor responsible for stress response in the pa-tients undergoing upper abdominal surgery.
出处
《临床麻醉学杂志》
CAS
CSCD
北大核心
1995年第4期206-208,共3页
Journal of Clinical Anesthesiology
基金
国家自然科学基金资助项目
