HANS仪辅助硬膜外阻滞时病人血清皮质醇和血糖的变化

CHANGES OF SERUM CORTISOL AND BLOOD GLUCOSE LEVEL IN PATIENTS UNDER EPIDURAL ANESTHESIA COMBINED WITH HANS ACUPOINT NERVE STIMULATOR

目的：观察妇科经腹全宫切除病人在硬膜外麻醉时辅以ＨＡＮＳ穴位刺激，是否能减轻内脏牵拉反应及相应的血液生化学变化。结果：硬膜外麻醉加ＨＡＮＳ组（＋ＨＡＮＳ）及单纯硬膜外麻醉（－ＨＡＮＳ）组各１５例。＋ＨＡＮＳ组术中有６６．７％的病例不出现牵拉反应，明显高于－ＨＡＮＳ组（２０％）；术中需要追加杜非合剂的病例（１３％），显著少于－ＨＡＮＳ组（５３％）。＋ＨＡＮＳ组术中血糖升高３３％，显著低于－ＨＡＮＳ组（升高４９％）。两组血清皮质醇水平的幅度相似，无显著差异。结论：硬膜外麻醉加用ＨＡＮＳ。

Thirty patients, undergoing hysterectomy, were randomly divided into epidural group (-HANS) and epidural combined with Hans acupoint nerve stimulator group (+HANS). The serum cortisol and blood glucose levels were studied. The visceral traction reaction during operation were also observed. The results showed that in the control (-HANS) group blood glucose were significantly incresed during the period of surgery and remained after the termination of operation. In the +HANS group, however, increase of blood glucose was found only at 5 minutes after surgery and was significantly lower than that of the control group. The level of serum cortisol in both groups increased significantly (P<0.01). There were no differences between two groups. The visceral traction reaction was significantly lower in +HANS group than the control (-HANS) group, and significantly less patients (13%) needed additional pethidine-phenergan injection in the +HANS group, as compared to the control group (53%). It is concluded that epidural anesthesia combined with HANS was more effective in reducing visceral traction reaction than epidural alone in patients undergoing abdominal surgery.