硬膜外或全身麻醉对上腹部手术患者血浆内皮素和心钠素的影响

Effects of epidural analgesia and general anesthesia on plasma ETand ANP in patients undergoing upper abdominal surgery

目的 :观察不同麻醉方法对上腹部手术患者血浆内皮素 (ET)和心钠素 (ANP)的影响。方法 :择期上腹部手术患者 2 0例 ,随机分为两组。Ⅰ组为硬膜外麻醉组 ,Ⅱ组为全身麻醉 (全麻 )组。于麻醉前、诱导后、手术 10min、手术 5 0min及术毕采静脉血 ,用放射免疫法测定血浆中ET和ANP的含量。结果 :ET在两组均无显著性变化 ,ANPⅠ组无明显变化 ,Ⅱ组术毕比术前明显升高 (P <0 .0 5 )。结论 :有效的硬膜外麻醉或全麻对上腹部手术患者术中血浆ET和ANP均无明显影响 ,但全麻手术结束时ANP显著升高 。

Objective To observe the effects of alternative anesthesia methods on plasma ET and ANP in the patients undergoing upper abdominal surgery.Methods Twenty patients,?undergoing elective upper abdominal surgery,?were randomly divided into two groups( n =10).Group Ⅰ was given epidural blockade,general anesthesia was used in group Ⅱ.Venous samples were taken at five time points of before anesthesia,after induction,at 10?min and 50?min after incision and at the end of surgery to measure contents of plasma ET and ANP by radioimmunoassay.Results The levels of plasma ET had no statistical difference in two groups.The levels of plasma ANP were not obviously changed in group Ⅰ.But,in comparison to the pre anesthetic value,plasma ANP was increased at the completion of operation in group Ⅱ( P <0.05).Conclusions Effective epidural blockage and general anesthesia were not significantly changes in plasma ET and ANP during the patients undergoing upper abdominal surgery.The significant increase of plasma ANP at the completion of operation by general anesthesia suggests that attention should be paid to preventing the cardiovascular response to extubation.