国产咪达唑仑复合静脉麻醉对肾素-血管紧张素-醛固酮系统的影响

Effect of Midazolam-fentanyl Intravenous Anesthesia on Renin-angiotensin-aldosterone System

目的 评价国产咪达唑仑复合芬太尼静脉麻醉时 ,机体对伤害性刺激的应激反应。方法 4 0例上腹部和胸部手术病人 ,随机分为咪达唑仑组和异氟醚组 ,在麻醉前、气管插管后 1min、手术探查时、病灶切除时 ,即刻抽取中心静脉血 ,放免法测定血浆肾素活性 ( PRA)、血管紧张素 ( A )、醛固酮( AL D)含量 ,并记录各时点的血流动力学变化。结果 咪达唑仑组和异氟醚组在各时点肾素活性、血管紧张素 、醛固酮水平差异均无显著性 ( P>0 .0 5) ,血流动力学比较亦无统计学意义 ( P>0 .0 5)。结论 咪达唑仑复合芬太尼、阿曲库铵静脉麻醉对机体的应激反应与吸入异氟醚麻醉的结果相似 ,均能较好地抑制机体对创伤性刺激的应激反应。

Objective To evaluate stress reaction of human to injury stimulation during total intravenous anesthesia with midazolam-fentanyl.Method Forty ASA gradeI-Ⅱ patients scheduled for abdominal or chest operation were randomly divided into two groups:midazolom-fentanyl intravenous anesthesia group and isoflurane inhalation group.Group midazolom-fentanyl:midazolom of 0.2mg·kg -1 ·h -1 +fentanyl of 2μg·kg -1 ·h -1 continous infusion by computer pump;group isoflurane:inhaling isoflurane of 1%～3%.The plasma rein(PRA),angiotensin Ⅱ(A Ⅱ),aldosterone(ALD) levels and hemodynamics were measured at pre-induction,one minuter after intubation,operative exploration and resection respectively.Result The levels of PRA,A Ⅱ,ALD and the values of hemodynamics between both groups were no significantly different(P>0.05) at various measurement time.Conclusion The stress reaction to human injury stimulation are inhibited effectively by midazolam-fentanyl intravenons anesthesia. [