骶管阻滞对小儿上腹部手术围术期IL-6和CRP的影响

Effect of Caudal Block on IL-6 and CRP during Upper Abdominal Surgery in Children

目的:评价全麻复合0.3%罗哌卡因骶管阻滞对小儿上腹部手术围术期IL-6和CRP的变化及对机体影响。方法:选择16例体重25kg以下,行择期上腹部手术患儿为研究对象。随机分成全麻复合骶管阻滞的实验组和单纯全麻的对照组。于麻醉开始前、切皮后5min、60min、术终时及术后24h抽取静脉血5ml检测血浆IL-6、CRP。结果:两组IL-6术毕及术后24h显著上升(P<0.05),术中两组CRP与麻醉前相比无显著变化,术后24h显著增加(P<0.01);两组间IL-6、CRP差异无显著性。对照组患儿MAP于切皮后5min和术毕时上升(P<0.05),而实验组MAP有所下降,60min时有统计学意义。对照组手术后心率与麻醉前相比上升(P<0.05),组间相比差异无显著性。结论:全麻复合0.3%罗哌卡因骶管阻滞不能抑制小儿上腹部手术引起IL-6和CRP的上升及对机体的应激影响。

Objective: To assess the effect of caudal block on IL-6 and CRP during upper abdominal surgery in children by measuring the perioperative changes of plasma IL-6, CRP levels. Methods:Sixteen children weight <25 kg , undergoing elective upper abdominal surgery were assigned in this study and randomly allocated to receive either general anesthesia (control group, n = 8) or general anesthesia combined with caudal block (caudal group, n = 8). Blood samples were obtained before induction of anesthesia, 5 min and 60 min after skin incision, at the end of surgery and 24h after surgery. Plasma IL-6, CRP level were determined. Results: The IL-6 level was increased significantly from baseline at the end of surgery and 24h after the surgery in both groups. The CRP level was increased significantly from baseline at 24h after the surgery in both groups. There were no significant differences between two groups in IL-6 and CRP levels. The MAP in the caudal group decreased at 60 min after skin incision, whereas the MAP in control group increased significantly from baseline values at 5 min after skin incision and at the end of surgery. There were no significant differences between two groups in heart rate. Conclusion: General anesthesia combined with 0. 3% ropivacaine caudal block can not suppress the stress responses during upper abdominal surgery in children.