术后镇痛对神经外科病人血浆内皮素-1的影响  

EFFECTS OF PATIENT-CONTROLLED INTRAVENOUS ANALGESIA ON PLASMA ENDOTHELIN LEVELS IN PATIENTS UNDERGOING CRANIOTOMY

作　　者：张咸伟[1] 张铁军[1] 田玉科[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院麻醉学教研室,武汉430030

出　　处：《中国疼痛医学杂志》2005年第2期77-80,共4页Chinese Journal of Pain Medicine

摘　　要：目的:观察术后静脉自控镇痛 (PCIA)对神经外科病人血浆内皮素 1 (ET 1)的影响。方法:48例择期开颅手术病人随机平均分为三组:TL组(曲马多 10mg·ml-1 +利多卡因 10mg·ml-1 );T组(曲马多 10mg·ml-1 );C组(未行镇痛组)。分别于麻醉诱导前、术后 6h、术后 18h采血,应用放射免疫法(RIA)检测血浆ET 1的水平。结果:TL组术后 6h及 18h的血浆ET 1水平与术前相比差异无显著性(P>0. 05),而T组和C组病人术后 6h及 18h的血浆ET-1水平较术前均显著增加(P<0. 01),TL组和T组病人术后 6h及 18h的血浆ET 1水平显著低于C组(P<0. 01)。结论:曲马多伍用利多卡因术后镇痛更能抑制术后应激导致的血浆ET 1水平增高,有利于防止继发性颅脑损伤。Objective:To study the effects of patient-controlled intravenous analgesia(PCIA) on plasma endothelin levels in patients undergoing craniotomy. Methods:Forty-eight patients undergoing elective craniotomy were randomly and evenly divided into three groups: group TL(tramadol 10 mg·ml -1 +lidocaine 10mg·ml -1 ),group T(tramadol 10mg·ml -1 ) and group C(control group). The plasma endothelin(ET-1) levels before induction and 6, 18 hours after craniotomy were detected using radio immunoassay(RIA). Results:Plasma ET-1 levels in group TL were significantly higher at 6, 18h after craniotomy than those before induction in group T and C( P <0.01), but the plasma ET-1 levels were not significantly changed before and after craniotomy in group TL( P >0.05). Conclusion:PCIA with tramadol associated lidocaine is the better to suppress the increase of plasma ET-1 levels in patients undergoing craniotomy and may contribute to prevent secondary craniocerebral injury.

关 键 词：术后镇痛 神经外科病人 血浆内皮素 内皮素-1(ET-1) ET-1水平 术后静脉自控镇痛 继发性颅脑损伤 血浆ET-1 利多卡因 放射免疫法 18h 曲马多 手术病人 麻醉诱导 人血浆 C组 显著性 术前 

分 类 号：R614[医药卫生—麻醉学]