硬膜外阻滞和N_2O-O_2-安氟醚吸入麻醉对围术期老年男性R-A-A系统的影响

Perioperative Effect of Epidural Blockade and N 2O O 2 Enflurane Anaesthesia on R A A System in the Aged Male Patients

２０例择期行前列腺摘除或膀胱肿瘤部分切除病人，随机分为两组，每组１０例，分别行硬膜外麻醉（双管法）和氧化亚氮－氧气－安氟醚（ＧＯＥ）吸入麻醉，测定麻醉和手术过程中血浆肾素活性，血管紧张素Ⅱ（ＡⅡ）和醛固酮（Ａｌｄ）浓度的变化，并进行比较。结果：硬膜外组病人的三者浓度在麻醉和手术过程中无明显变化，而ＧＯＥ组麻醉和手术使ＲＡＡ浓度显著升高，两组差异高度显著。结论：双管法硬膜外阻滞可消除盆腔手术病人手术引起的肾素、血管紧张素和醛固酮反应，而ＧＯＥ吸入麻醉却无这方面作用。

Plasma renin activity(PRA),angiotensinⅡ(AⅡ) and aldosterone(Ald) concentrations were measured perioperatively in two groups of aged male patients (10 patients each),receiving suprapubic prostatectomy and partial cystectomy under either epidural blockade or N 2O O 2 enflurane inhalation general anaesthesia.Results show that those under general anaesthesia,had a marked increase in PRA,AⅡ and Ald,while in those with epidural blockade,the responses were inhibited.It is concluded that epidural blockade can inhibit the response of PRA,AⅡ and Ald to prostatectomy and patial cystectomy,while N 2O O 2 enflurane inhalation general anaesthesia has no such effect.