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1、不同麻醉用药及不同麻醉方法对术中应激反应影响【摘要】目的比较不同麻醉用药与不同麻醉方法对术中应激反应的影响。方法选60例年龄18~65岁,性别、身高、体重比较均无显著性差异,ASA分类Ⅰ-Ⅱ级,择期胃肠,胆囊,肾手术病例,分为硬膜外加全麻气管插管组(EG组)或喉罩组(EGL组)、瑞芬太尼加吸入麻醉组(RI组)、瑞芬太尼+异丙酚全静脉麻醉(RP组)各15例;术中连续监测血压、心电图、脉搏氧饱和度;呼气末二氧化碳;术前、诱导后、切皮后、术毕取血测血浆肾上腺素和去甲肾上腺素、血管紧张素Ⅰ和血管紧张素Ⅱ、胰高糖素和血糖。结果不同麻醉用药与不同麻醉方
2、法在各时间点内激素水平不相同,不同麻醉用药与不同麻醉方法时血压心率变化也存在很大差异。结论在术中不同麻醉用药与不同麻醉方法会导致不同的应激反应。【关键词】麻醉用药;麻醉方法;应激反应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作者单位:610071四川华美紫馨医学美容医院(周激);成都市第九人民医院(张小丽)1资料与方法1.1一般资料选60例年龄18~65岁,性别、身高、体重比较均无显著性差异,ASA分类Ⅰ-Ⅱ级,择期胃肠,胆囊,肾手术病例,分为硬膜外加全麻气管插管组(EG组)或喉罩组(EGL组)、瑞芬太尼加吸入麻醉组(RI组)、瑞芬太尼+异丙酚全静
8、脉麻醉(RP组)各15例。1.2方法术中连续监测血压、心电图、脉搏氧饱和度;呼气末二氧化碳;术前、诱导后、切皮后、术毕取血测血浆肾上腺素和去甲肾上腺素、血管紧张素Ⅰ和血管紧张素Ⅱ
