地氟醚对手术病人肾素-血管紧张素-醛固酮系统及皮质醇的影响

The effects of desflurane on renin-angiotension-aldosterone system and plasma cortisone concentration in surgical patients

目的 观察地氟醚在手术中对肾素 血管紧张素 醛固酮系统 (RAAS)及皮质醇的影响。方法 选择 30例择期在全麻下实施上腹部手术病人 ,随机分为地氟醚组和安氟醚组 ,每组 15例。术中分五个时点采集静脉血 ,以放免法测定血浆肾素活性 (PRA)、血管紧张素Ⅱ (AⅡ )、醛固酮 (Al)及皮质醇 (Cor)。结果 地氟醚组在切皮时即出现PRA、AⅡ、Al的升高 ,尤以Al显著 ,术中继续升高。两组Cor术中均升高 ,但无明显组间差异。地氟醚组术中血压及心率增加明显。结论 地氟醚可早期激活RAAS ,并有交感兴奋作用 ;

Objective To investigate the effects of desflurane on renin angiotension aldosterone(RAAS) and cortisone(Cor) during upper abdominal surgery under inhalational anesthesia.Methods 30 patients undergoing upper abdominal surgery were randomly assigned to group enflurane and group desflurane with 15 cases each.The blood samples were taken for the measurements of the concentration of plasma renin activity(PRA),angiotensionⅡ(AⅡ),aldosterone(Al) and Cor at five time points during operation.Results The concentration of PRA,AⅡ and Al began to increase during incision and even more during operation.BP and HR increased significantly during surgery.The concentration of Cor was increased as well during operation,but there was no difference between two groups.Conclusion Desflurane may activate RAAS early and sympathetic system.Desflurane anesthesia can not restrain the Cor elevation responding to operative stimulation. [