罗哌卡因星状神经节阻滞对体外循环术中炎症反应影响

The effect of stellate ganglion block with ropivacaine on inflammatory reaction in patients undergoing cardiopulmonary bypass

目的探讨罗哌卡因应用于星状神经节阻滞(SGB)对体外循环术后患者炎症反应的影响。方法将20例需进行二尖瓣置换的手术患者随机分为对照组、SGB组各10例。对照组无处理,SGB组予以0.5%罗哌卡因进行SGB。分别于术前20min、麻醉后20 min、手术20 min、体外循环20 min、体外循环后20 min取血标本,检测血糖、皮质醇(Cor)、白介素-1β(IL-1β)、白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)的血浆浓度。结果 IL-1β均呈上升趋势,在体外循环后20 min时,SGB组比对照组明显降低,差异有统计学意义(P<0.05)。SGB组血糖、CorI、L-6、TNF-α在体外循环20 min、体外循环后20 min血浆浓度明显低于对照组(P<0.05)。结论罗哌卡因应用于SGB可有效地减轻体外循环引起的炎症反应。

Objective To study the effect of stellate ganglion block with ropivacaine on inflammatory reaction in patients undergoing cardiopulmonary bypass.Methods Twenty patients undergoing mitral valve replacement were randomLy allocated to two groups,control group and SGB group（n=10）.The control group was not treated.The SGB group was stellate blocked with 0.5% ropivacaine.The samples were taken at twenty minutes before the anesthesia（T1）,twenty minutes after the anesthesia（T2）,twenty minutes after the surgery（T3）,twenty minutes during CPB（T4） and twenty minutes afterCPB（T5）.Results IL-1βof the control group is higher than the SGB group at T5（P〈0.05）.BG、Cor、IL-6、TNF-α of the control group are lower than the control group at T4 and T5.Conclusion Stellate ganglion block with ropivacaine can relieve inflammatory reaction induced by CPB.The mechanism need explore in the future.