Galoić-Krleza R
Zavod za anesteziologiju i intenzivno lijecenje, Klinicka bolnica Sestre milosrdnice, Zagreb.
Lijec Vjesn. 1991 Sep-Oct;113(9-10):327-32.
In search of an anesthetic technique which would inhibit response to surgery stress, we tried to obtain a new method by a combination of a commonly used neuroleptanalgesia (NLA) and a traditional Chinese acupuncture, in which by increasing the level of endogenic opioid peptides we would decrease the need for exogenic opiates and thus influence the body response to surgery. The effect of this combined use of NLA and acupuncture was evaluated on the hyperglykemia, cortisol and aldosterone response during pre, intra and postoperative period, fentanyl and dehydrobenzperidol (DHBP) requirements, and its postoperative analgetic and antiemetic efficacy. The patient population comprised 40 metabolically healthy patients randomly divided into experimental and control group. Using the analysis with t-test we have demonstrated that acupuncture, as and adjuvant to NLA, significantly suppresses the hyperglykemia and cortisol response to surgery stress, while it does not influence the aldosterone mechanism and, it significantly reduces fentanyl and DHBP requirements. With chi 2-test we have shown a significant decrease in postoperative vomiting and pain, and as a result of this, a reduction of analgesic requirements. In summary, a combination of neuroleptanalgesia and acupuncture can be recommended as a technique which significantly supresses the response to surgery stress (intraoperative hyperglykemia and hypercortisolism) and can be easily applied in the majority of surgical procedures.
为寻找一种能抑制手术应激反应的麻醉技术，我们尝试通过将常用的神经安定镇痛术（NLA）与传统中医针灸相结合来获得一种新方法，即通过提高内源性阿片肽水平来减少对外源性阿片类药物的需求，从而影响机体对手术的反应。我们评估了NLA与针灸联合使用对术前、术中和术后高血糖、皮质醇和醛固酮反应、芬太尼和氟哌利多（DHBP）需求量及其术后镇痛和止吐效果的影响。患者群体包括40名代谢健康的患者，随机分为实验组和对照组。通过t检验分析，我们证明针灸作为NLA的辅助手段，能显著抑制手术应激引起的高血糖和皮质醇反应，同时不影响醛固酮机制，且能显著降低芬太尼和DHBP的需求量。通过卡方检验，我们发现术后呕吐和疼痛显著减少，因此镇痛药物的需求量也有所降低。总之，神经安定镇痛术与针灸的联合应用可作为一种能显著抑制手术应激反应（术中高血糖和高皮质醇血症）且易于应用于大多数外科手术的技术被推荐。
