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拉贝洛尔与异氟烷诱导低血压期间的血浆肾素、儿茶酚胺、血管加压素和醛固酮

Plasma renin, catecholamines, vasopressin and aldosterone during hypotension induced by labetalol with isoflurane.

作者信息

Toivonen J

机构信息

Department of Anaesthesia, South Saimaa Central Hospital, Lappeenranta, Finland.

出版信息

Acta Anaesthesiol Scand. 1991 Aug;35(6):496-501. doi: 10.1111/j.1399-6576.1991.tb03336.x.

Abstract

Deliberate hypotension may induce secretion of stress hormones. In the present study, the effects of hypotension induced by labetalol with isoflurane or plasma renin activity, plasma concentrations of adrenaline, noradrenaline, vasopressin, and aldosterone were investigated in eight adult patients undergoing middle-ear surgery. The mean arterial pressure was 50 mmHg (6.7 kPa) during hypotension. Plasma renin activity rose significantly during anaesthesia before hypotension, being similar during hypotension and before hypotension, and in returned postoperatively to the initial level. Plasma adrenaline fell significantly during hypotension and rose after anaesthesia to the preanaesthetic level. Plasma noradrenaline rose slightly during hypotension and after anaesthesia, but not significantly. Plasma vasopressin rose significantly after anaesthesia. Plasma aldosterone increased slightly throughout the study, but not significantly during any phase. In conclusion, labetalol with isoflurane-induced hypotension seems to attenuate the stress response in these operations. During hypotension, plasma renin activity is not an essential compensatory mechanism, which antagonises the decrease of blood pressure. Plasma vasopressin has no role in regulating blood pressure during labetalol-induced hypotension.

摘要

控制性低血压可能会诱导应激激素的分泌。在本研究中,对8例接受中耳手术的成年患者,研究了拉贝洛尔联合异氟烷所致低血压或血浆肾素活性、血浆肾上腺素、去甲肾上腺素、血管加压素及醛固酮浓度的影响。低血压期间平均动脉压为50 mmHg(6.7 kPa)。血浆肾素活性在低血压前的麻醉期间显著升高,在低血压期间和低血压前相似,术后恢复至初始水平。血浆肾上腺素在低血压期间显著下降,麻醉后升至麻醉前水平。血浆去甲肾上腺素在低血压期间及麻醉后略有升高,但无显著意义。血浆血管加压素在麻醉后显著升高。血浆醛固酮在整个研究过程中略有增加,但在任何阶段均无显著变化。总之,拉贝洛尔联合异氟烷所致低血压似乎可减轻这些手术中的应激反应。在低血压期间,血浆肾素活性并非对抗血压下降的必需代偿机制。在拉贝洛尔所致低血压期间,血浆血管加压素对血压调节无作用。

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