摘要
目的 :讨论全麻结合硬膜外阻滞并术后镇痛对上腹部手术围术期应激反应和糖代谢的影响。方法 :择期上腹部手术 5 4例 ,随机分为三组 ,每组 18例 ,Ⅰ组全麻结合硬膜外阻滞并术后镇痛 ,Ⅱ组硬膜外阻滞并施术后镇痛 ,Ⅲ组硬膜外阻滞不保留术后镇痛。观察围术期血糖 (BS)和胰岛素 (Ins)的浓度变化。结果 :Ⅰ组术中和术后BS平稳。Ⅱ、Ⅲ组术中和手术结束时BS明显升高 ,但术后 2 4hⅡ组降到正常 ,Ⅲ组仍显著升高。术后三组Ins均有明显升高。结论 :全麻结合硬膜外阻滞并施术后镇痛较单纯硬膜外麻醉能更有效地减轻围术期应激反应。
Objective:To evaluate the effect of general anesthesia combined with epidural block and postoperative epidural analgesia on perioperative blood sugar(BS)and insulin(Ins)in patients undergoing upper abdominal surgery Methods:54 patients undergoing elective upper abdominal surgery were allocated into 3 groups with 18 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 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 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
《广州医药》
2002年第3期18-21,共4页
Guangzhou Medical Journal
