内分泌激素RIA在不同全麻诱导药麻醉过程中的临床观察

The RIA Studies on The Changes of Serum Hormone Levels During Induction Stage of Intravenous Anesthesia With Three Different Drugs

目的 :评价三种静脉麻醉药 ,在全麻诱导时对内分泌功能的影响。方法 :将择期全麻手术病人48例 ,随机分为三组 :Ⅰ组异丙酚组 18例 ,Ⅱ组硫喷妥钠组和Ⅲ组依托咪酯组各 15例 ,在诱导前 (T0 ) ,窥喉插管即刻 (T1) ,插管后 (T2 ) ,5min(T3 ) ,15min(T4 )取外周静脉血 ,用放射免疫法测定血浆去甲肾上腺素 (NE) ,肾上腺素 (E) ,皮质醇 (Cort) ,泌乳素 (PRL) ,生长素 (GH) ,β -内啡肽 (β-EP)水平。 结果 :三药在气管插管诱导期 ,无一能抑制NE分泌 ,但异丙酚对NE及垂体内分泌影响较小 ,优于硫喷妥钠和依托咪酯。结论 :三类全麻诱导药相比较异丙酚在抑制NE分泌及对内分泌影响方面 ,其安全性优于硫喷妥钠和依托咪酯。

Objective To investigate of effects of propofol, thiopental and etomidate on pituitaryadrenal functions during the induction stage of intravenous anasthesia with them. Methods Forty-eight patients undergoing elective surgery were randomly divided into three groups. propofol (groupⅠ), thipental (groupⅡ) and etomidate (groupⅢ). Peripheral blood samples were taken for the measurement of E, NE, PRL, GH, B-EP and cortisone before induction (T_0), During induction (T_1) and 2, 5, 15min after intubation with RIA. Results The study showed that none of the three drugs could inhibit increase in E and NE during induction and intubation, but propofol was significantly better than the other two. Conclusion Propofol has less effects on pituitary-adrenal functions and is the drug of choice for induction.