上胸段硬膜外阻滞对地氟醚快速洗入机体应激反应的影响  

Effect of High Thoracic Epidural Block on Stress Reaction during Desflurane Fast-Inflow

作　　者：冯翠[1] 刘晓鸣[1] 

机构地区：[1]哈尔滨医科大学附属第四医院,哈尔滨150001

出　　处：《中国医药导刊》2011年第10期1665-1666,共2页Chinese Journal of Medicinal Guide

摘　　要：目的:观察上胸段硬膜外阻滞对地氟醚快速洗入机体应激反应的影响。方法:40例择期腹部外科手术患者,随机双盲分成地氟醚组(D组)和硬膜外阻滞复合地氟醚组(DE组)。麻醉诱导后,两组快速吸入地氟醚,分别记录诱导前、0.5MAC、1.0MAC及1.5MAC的MBP、HR、SVR、CI、SI、LCWI及RPP,于诱导前及1.5MAC采取静脉血,放免法测定血浆E及NE的浓度。结果:DE组的MBP、SVR、LCWI、RPP随着MAC的增加下降(P<0.05);D组的HR、RPP在1.5MAC时高于1.0MAC和DE组(P<0.05);D组的E及NE在1.5MAC时升高(P<0.05),且高于DE组(P<0.05);DE差别不显著(P>0.05)。两组的CI及S1无变化(P>0.05)。结论:上胸段硬膜外阻滞能抑制地氟醚快速洗入时E及NE的释放,稳定心功能,降低应激反应。Objective： To study the effect of high thoracic epidural block on stress reaction during desfluranc fast-inftow.Methods： 40 patients of elective abdominal surgery were randomly double-blind assigned into dcsflurane group （group D） and high thoracic epidural block combined with desflurane group （group DE）.After induction of anesthesia, the patients of two groups were rapidly inflowed with 0.5MAC, 1.0MAC and 1.5MAC desflurane.Recorded MBRHR,SVR,CI,SI,LCWI and RPP during before induction, 0.5MAC,1.0MAC and t.SMAC respectively.Determined plasma epinephrine（E） and norcpinephrine（NE） concentration with radioimnmnoassay before induction and in 1.5 MAC.Results： In group DE, MBP, SVR,LCWI,RPP were significantly decreased with the increase in MAC （P〈0.05）： In Group D, HR,RPP in 1.5MAC were higher than that in 1.0MAC and that in DE group（P〈0.05）; In Group D, F and NE in 1.5 MAC were significantly higher than that in baseline and that in group DIZ（P〈0.05）; The plasma concentration of E or NE was not significant diffcrence between 1.5MAC and baseline in group DE（P〉0.05）.There was not significant difference in C1 or St in the two groups （P〉 0.05）.Conclusion： The high thoracic epidural block can restrain releasing of E and NE during desilurane fast -inflow and was beneficial to heart function, restram the stress reaction.

关 键 词：地氟醚 应激反应 血流动力学 交感神经 硬膜外阻滞 

分 类 号：R614[医药卫生—麻醉学]