芬太尼麻醉手术中血糖和胰岛素的变化

Influence of fentanyl anesthesia on blood glucose and insuline in upper abdomined operations

目的：观察芬太尼麻醉手术中机体的血糖（ Ｇ Ｌ Ｕ） 和胰岛素（ Ｉ Ｎ Ｓ） 的变化。方法：选择３３例 Ａ Ｓ Ａ Ⅰ－ Ⅱ择期上腹部手术患者，诱导后持续恒定静脉内输入芬太尼维持到手术缝皮后为止，３组剂量分别为每小时每公斤体重２５ 、５ 、７５ μｇ 。分诱导前（ Ｔ１） 、手术７０ ｍｉｎ（ Ｔ２） 、术毕（ Ｔ３）３ 次采静脉血，测血糖和胰岛素值。用 Ｓ Ｐ Ｓ Ｓ 软件包进行数据处理，采用方差分析和相关分析。结果：不同剂量的３ 组在手术７０ ｍｉｎ 时、术毕的血糖值与术前比较有显著性增高（ Ｐ＜ ０ ．０５） 。术毕（ Ｔ３） 第Ⅰ组胰岛素与Ⅱ、Ⅲ组比较有显著性增高（ Ｐ＜ ０ ．０５） 。血糖和胰岛素呈弱正相关（ ｒ＝ ０２０６） 。结论：以上３ 种剂量的芬太尼维持麻醉，术中和术毕血糖均升高，在应激状态下。

Aim:To observe the changes of blood glucose and insuline in upper abdominal operation with fentanyl anesthesia. Methods:Thirty-three ASA grade 1-2, in terms of intravenous fentanyl maintaiment dosages from post-induction to the end of sutua of skin were randomly allocated into three groups: 2 5 μg/(kg·h) group Ⅰ( n =12, group 1), 5 μg/(kg·h) group Ⅱ ( n =13, group 2) 7 5 μg/(kg·h) group Ⅲ ( n =8, group 3). Blood glucose and insuline at the time of preinduction, 70th minutes and the end afteroperations were measured respectively. Results:Blood glucose level of all patients at the 70th minutes and the end of operation increased significantly ( P <0.05) compared with that before operation, in group Ⅰ rose obviously compared with that before operation and after induction, blood insuline values at the end of operation in group Ⅰ rose obviously compared with that of group Ⅱ and group Ⅲ ( P <0.05). Blood glucose and insuline was in slight positive relation. Conclusion:It is suggested that in intravenous fentany1 anesthesia, at different dosages, blood glucose and insuline level both increase, but the fronter is not sensitve to the later