Misiołek H, Wojcieszek E, Dyaczyńska-Herman A
Department of Anesthesiology and Intensive Care, Silesian Medical University, ul. 3 Maja 13/15, 41-800 Zabrze, Poland.
Med Sci Monit. 2000 Mar-Apr;6(2):319-24.
The stress hormones plasma concentration after intravenous anesthetics (thiopentone, propofol, midazolam) administration in patients who underwent non-toxic struma operation was estimated. The goal of the study was to answer what stage of the general anesthesia and the surgery is the most dangerous for the cardiovascular system in term of stress hormones concentration and which of induction anesthetics used significantly alleviates undesirable reactions to surgical trauma and general anesthesia. 45 women aged 43 +/- 11, who underwent non-toxic struma operation and 16 women who underwent biliary gall-stones operation served as the 'study group and controls', respectively. Both groups were divided into 3 subgroups (in each a different anesthetic was used). Blood samples were taken at moments of increased stress during general anesthesia and operation. Intubation performed by laryngoscopy was found as the most stressful moment at which stress hormones are released intensively and can initiate cardiovascular disorders. According to our investigations, the suppression of the stress hormones (noradrenaline and cortisol) release was observed when propofol and midazolam were used for anesthesia induction for non-toxic struma surgery in contrast to thiopentone administration.
对接受非毒性甲状腺肿手术的患者静脉注射麻醉剂(硫喷妥钠、丙泊酚、咪达唑仑)后应激激素的血浆浓度进行了评估。该研究的目的是回答就应激激素浓度而言,全身麻醉和手术的哪个阶段对心血管系统最危险,以及所使用的诱导麻醉剂中哪种能显著减轻对手术创伤和全身麻醉的不良反应。45名年龄在43±11岁、接受非毒性甲状腺肿手术的女性和16名接受胆结石手术的女性分别作为“研究组和对照组”。两组均分为3个亚组(每组使用不同的麻醉剂)。在全身麻醉和手术期间应激增加的时刻采集血样。通过喉镜进行气管插管被发现是最具压力的时刻,此时应激激素会大量释放并可能引发心血管疾病。根据我们的研究,与使用硫喷妥钠相比,在非毒性甲状腺肿手术中使用丙泊酚和咪达唑仑进行麻醉诱导时,观察到应激激素(去甲肾上腺素和皮质醇)的释放受到抑制。