不同麻醉用藥及不同麻醉方法對術(shù)中應(yīng)激反應(yīng)影響

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1、不同麻醉用藥及不同麻醉方法對術(shù)中應(yīng)激反應(yīng)影響【摘要】目的比較不同麻醉用藥與不同麻醉方法對術(shù)中應(yīng)激反應(yīng)的影響。方法選60例年齡18~65歲,性別、身高、體重比較均無顯著性差異,ASA分類Ⅰ-Ⅱ級,擇期胃腸,膽囊,腎手術(shù)病例,分為硬膜外加全麻氣管插管組(EG組)或喉罩組(EGL組)、瑞芬太尼加吸入麻醉組(RI組)、瑞芬太尼+異丙酚全靜脈麻醉(RP組)各15例;術(shù)中連續(xù)監(jiān)測血壓、心電圖、脈搏氧飽和度;呼氣末二氧化碳;術(shù)前、誘導(dǎo)后、切皮后、術(shù)畢取血測血漿腎上腺素和去甲腎上腺素、血管緊張素Ⅰ和血管緊張素Ⅱ、胰高糖素和血糖。結(jié)果不同麻醉用藥與不同麻醉方

2、法在各時間點內(nèi)激素水平不相同,不同麻醉用藥與不同麻醉方法時血壓心率變化也存在很大差異。結(jié)論在術(shù)中不同麻醉用藥與不同麻醉方法會導(dǎo)致不同的應(yīng)激反應(yīng)?！娟P(guān)鍵詞】麻醉用藥;麻醉方法;應(yīng)激反應(yīng)OfdifferentanestheticagentswithdifferentanesthesiamethodsonintraoperativestressresponseZHOUJi-Zi,ZHANGXiao-li.XinSichuanChinaandtheUnitedStatesMedicalBeautyHospital,Chendu610071,Chin

3、a5【Abstract】ObjectiveComparisonofdifferentanestheticaEGntswithdifferentanesthesiaonintraoperativestressresponse.MethodsSelected60casesofaEG18-65yearsold,eachgroupsex,height,weight,comparednosignificantdifferencein,ASAclassificationⅠ-Ⅱlevel,electivegastrointestinal,gallblad

4、der,nephronsparingsurEGrycaseswasdividedintoepiduralanesthesiaplusintubationgroup(EGgroup)orlarynEGalmaskairwaygroup(EGLgroup),remifentanilplusinhalationanesthesiagroup(RIgroup),remifentanil+propofoltotalintravenousanesthesia(RPgroup)ofthe15cases,intraoperativecontinuousmo

5、nitoringofbloodpressure,electrocardiogram,pulseoxyEGnsaturation;end-tidalcarbondioxide;Preoperative,induction,afterincision,intraoperativecompletionofbloodsamplingtomeasureplasmaepinephrineandnorepinephrine,angiotensinⅠandangiotensinⅡ,glucagonandbloodglucose.ResultsOfdiffe

6、rentanestheticaEGntswithdifferentanesthesiamethods5atalltimepointswithinthehormonelevelwasnotthesame,differentanestheticaEGntswithdifferentanesthesiamethodsofbloodpressureandheartratechanEGshadalsovariedgreatly.ConclusionDuringtheoperationofdifferentanestheticaEGntswithdif

7、ferentanesthesiamethodswillleadtodifferentstressresponse.【Keywords】Anestheticdrugs;Anesthesia;Stressresponse作者單位:610071四川華美紫馨醫(yī)學(xué)美容醫(yī)院(周激);成都市第九人民醫(yī)院(張小麗)1資料與方法1.1一般資料選60例年齡18~65歲,性別、身高、體重比較均無顯著性差異,ASA分類Ⅰ-Ⅱ級,擇期胃腸,膽囊,腎手術(shù)病例,分為硬膜外加全麻氣管插管組(EG組)或喉罩組(EGL組)、瑞芬太尼加吸入麻醉組(RI組)、瑞芬太尼+異丙酚全靜

8、脈麻醉(RP組)各15例。1.2方法術(shù)中連續(xù)監(jiān)測血壓、心電圖、脈搏氧飽和度;呼氣末二氧化碳;術(shù)前、誘導(dǎo)后、切皮后、術(shù)畢取血測血漿腎上腺素和去甲腎上腺素、血管緊張素Ⅰ和血管緊張素Ⅱ