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手术及全身麻醉或硬膜外麻醉对一岁以下婴儿血浆皮质醇、生长激素和催乳素水平的影响。

Effects of surgery and general or epidural anesthesia on plasma levels of cortisol, growth hormone and prolactin in infants under one year of age.

作者信息

Salerno R, Forti G, Busoni P, Casadio C

机构信息

Dipartimento di Fisiopatologia Clinica, Università di Firenze, Italy.

出版信息

J Endocrinol Invest. 1989 Oct;12(9):617-21. doi: 10.1007/BF03350019.

DOI:10.1007/BF03350019
PMID:2584638
Abstract

Twenty infants under one yr of age undergoing minor surgery were divided in two groups according to the type of anesthesia (epidural, Group 1, n = 10; general, Group 2, n = 10) which was randomly performed. Blood samples for cortisol (F), growth hormone (GH), and prolactin (PRL) determination were taken from each infant in baseline conditions, before surgery, and at the end of surgery. Mean plasma F levels in infants of group 2 rose significantly (p less than 0.01) before surgery to attend a maximum at the end of surgery (p less than 0.005). In infants of Group 1 a significant increase was also observed before surgery (p less than 0.05) but at the end of surgery mean plasma cortisol returned to levels comparable to baseline. Mean GH plasma levels were not significantly affected by both types of anesthesia, however an increase (not statistically significant) was observed at the end of surgery in both groups. Mean plasma PRL levels showed a significant increase before surgery (p less than 0.05 and p less than 0.01 in group 1 and 2, respectively) and a further increase at the end of surgery in both groups of infants (p less than 0.005). These results suggest that in infants under one yr of age both types of anesthetic procedures preceding surgery have no significant effect on plasma GH, but produce a significant increase of cortisol and prolactin mean plasma levels. The cortisol response to surgery and general or epidural anesthesia was similar to that reported in adults and prepubertal boys.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

20名1岁以下接受小手术的婴儿根据随机实施的麻醉类型(硬膜外麻醉,第1组,n = 10;全身麻醉,第2组,n = 10)被分为两组。在基线状态、手术前和手术结束时,从每个婴儿采集血样以测定皮质醇(F)、生长激素(GH)和催乳素(PRL)。第2组婴儿的血浆F平均水平在手术前显著升高(p < 0.01),在手术结束时达到最高值(p < 0.005)。在第1组婴儿中,手术前也观察到显著升高(p < 0.05),但在手术结束时血浆皮质醇平均水平恢复到与基线相当的水平。两种麻醉方式对平均GH血浆水平均无显著影响,然而两组在手术结束时均观察到升高(无统计学意义)。两组婴儿的平均血浆PRL水平在手术前均显著升高(第1组和第2组分别为p < 0.05和p < 0.01),且在手术结束时进一步升高(p < 0.005)。这些结果表明,1岁以下婴儿手术前的两种麻醉方式对血浆GH均无显著影响,但会使皮质醇和催乳素的平均血浆水平显著升高。手术及全身或硬膜外麻醉时皮质醇的反应与成人及青春期前男孩的报道相似。(摘要截断于250字)

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本文引用的文献

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Randomised trial of fentanyl anaesthesia in preterm babies undergoing surgery: effects on the stress response.芬太尼麻醉在早产儿手术中的随机试验:对应激反应的影响。
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Prolactin, LH, FSH, GH and cortisol response to surgery and the effect of epidural analgesia.催乳素、促黄体生成素、促卵泡生成素、生长激素及皮质醇对手术的反应以及硬膜外镇痛的作用。
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