全麻复合硬膜外阻滞对老年人上腹部手术围术期皮质醇和IL-6的影响

EFFECTS OF COMBINED GENERAL-EPIDURAL ANESTHESIA ON PLASMA LEVEL OF CORTISOL AND IL-6 IN ELDERLY PATIENTS UNDERGOING UPPER ABDOMINAL SURGERY

目的观察全麻复合硬膜外阻滞对老年上腹部手术病人血清皮质醇和IL-6的影响。方法30例老年上腹部手术病人随机分为全麻组(Ⅰ组)和全麻复合硬膜外组(Ⅱ),分别于麻醉前(T1)、手术60min(T2)、术毕(T3)、术后1天(T4)经颈内静脉采血5ml,测定其血清皮质醇、IL-6水平。结果Ⅰ组皮质醇浓度在T2、T3、T4明显高于T(1P<0.05),IL-6浓度仅在T4高于T(1P<0.05)。Ⅱ组在T2、T3、T4皮质醇及IL-6浓度与T1比较无明显变化。结论全麻复合硬膜外阻滞麻醉对血清皮质醇和IL-6影响较小,更适用于老年上腹部手术。

Objective To investigate the effects of combined general-epidural anesthesia on plasma level of cortisol and IL-6 in elderly patients undergoing upper abdominal surgery .Methods Thirty elderly patients (17 male,13 female) aged 65-78 yr undergoing upper abdominal surgery were randomly divided into 2 groups: groupⅠ(n=15) received general anesthesia, group Ⅱ (n=15) received combined general-epidural anesthesia. Blood samples were taken via internal jugular vein before anesthesia (T1), 60min after surgery (T2), end of surgery (T3),and 1day after surgery (T4) for determination of plasma levels of cortisol,IL-6. Results In groupⅠthe plasma concentrations of cortisol were significantly higher at T2￣4 than at T(1P <0.05). The plasma concentrations of IL-6 were higher at T4 than at T(1P < 0.05).There were no significant difference in plasma cortisol and IL-6 at T1￣4 in groupⅡ. Conclusions Combined general-epidural anesthesia can reduce the influence of plasma cortisol and IL-6 in elderly patients undergoing upper abdominal surgery, being suitable for these patients.